Conjunctivitis & Ocular Surface Disease
Assess discharge, irritation and tear-film disease while preserving diagnostic safety.
Quick revision ↓ Medical Dictionary
01Infective conjunctivitis
Viral conjunctivitis commonly produces watery discharge and may follow a respiratory illness; bacterial disease may cause mucopurulent discharge. Clinical overlap is substantial. Check vision and the cornea before assuming uncomplicated infection. Marked pain, photophobia, copious purulence or systemic risk warrants escalation. Treatment choices depend on severity, likely cause and local antimicrobial guidance.
02Transmission and hygiene
Encourage hand hygiene and avoidance of shared towels or contaminated eye products. Contact lenses should be stopped during active symptoms and resumed only when appropriate after recovery and advice. Do not share prescribed drops. Explain expected recovery and return precautions, because persistence or deterioration can indicate an alternative diagnosis or corneal involvement.
03Allergic disease
Allergic conjunctivitis often affects both eyes with itch, watering and associated atopy. Allergen avoidance, lubricants and appropriate topical antiallergic treatment may help. Severe allergic eye disease can involve the cornea and needs specialist assessment. Repeated steroid treatment without monitoring is unsafe because pressure elevation, cataract and infection are possible complications.
04Dry eye and tear film
Dry eye can cause burning, grittiness and fluctuating blur, sometimes with reflex watering. Tear production, evaporation, blinking, environment and medicines contribute. Review screen habits, lid disease and systemic symptoms where relevant. Lubricants and appropriate lid or environmental measures are selected individually; persistent pain or reduced vision requires reconsideration rather than assuming all symptoms are dryness.
05Special presentations
Neonatal conjunctivitis, hyperacute purulent discharge and suspected sexually transmitted infection need urgent or specialist pathways. Take a respectful history and arrange appropriate testing and treatment with confidentiality. Recurrent unilateral symptoms or poor response should prompt a review for foreign body, lacrimal disease or another cause. Avoid a reflex cycle of repeated antibiotic prescriptions without reassessment.
High-Yield Revision
- Watery eyes can occur in dry-eye disease.
- Severe purulence and neonatal disease need urgent pathways.
- Persistent unilateral symptoms deserve diagnostic review.
Common Pitfalls
- Assuming every red eye benefits from antibiotics.
- Repeating treatment indefinitely without re-examination.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.