Acute Conjunctivitis

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ophtho question --

for acute nonpainful supporative conjunctivitis, I saw an ER doctor prescribe erithromycin ointment and prednisolone drops. i've heard steroids in the presence of eye infections can be a touchy subject. On the one hand, if it's bacterial, supposedly the erythromycin is broad enough to cover the infection and the steroids will cut back on inflammation (what if it's nosocomial? does that make a difference in virulence/abx coverage?). On the other hand, if it's viral, the steroids will cause immunosuppression without any aid to kill the causative agent.

is this something that is commonly done, adding steroids? Does it add any benefit to decreasing the length of illness or is it just to ease the irritation?

thanks

PS - on a side note, can you use bacitracin ointment (2nd line rx behind erythro) that you find in the hospital, you know for abrasions and such, instead of the ophthalmic bacitracin ointment? Is there really any difference? Maybe mix it with some vaseline if there's a concetration discrepency?

thanks again

 

[JMK2005]

Unfortunately, SDN is not an appropriate forum for medical advice. I recommend you see an ophthalmologist for evaluation and followup.

 

[PBEA]

ophtho question --

for acute nonpainful supporative conjunctivitis, I saw an ER doctor prescribe erithromycin ointment and prednisolone drops. i've heard steroids in the presence of eye infections can be a touchy subject. On the one hand, if it's bacterial, supposedly the erythromycin is broad enough to cover the infection and the steroids will cut back on inflammation (what if it's nosocomial? does that make a difference in virulence/abx coverage?). On the other hand, if it's viral, the steroids will cause immunosuppression without any aid to kill the causative agent.

is this something that is commonly done, adding steroids? Does it add any benefit to decreasing the length of illness or is it just to ease the irritation?

thanks

PS - on a side note, can you use bacitracin ointment (2nd line rx behind erythro) that you find in the hospital, you know for abrasions and such, instead of the ophthalmic bacitracin ointment? Is there really any difference? Maybe mix it with some vaseline if there's a concetration discrepency?

thanks again

since an "ER doc" or other non eye doctor is "treating" eye disease based primarily on empirical evidence, it would make NO SENSE WHATSOEVER for the "ER doc" to prescribe ophthalmic steroid in ANY case. The use of erythromycin is possibly worthless (except as a palliative, and since when does emycin have "broad coverage"?) since we can't be sure what kind of "acute nonpainful supporative conjunctivitis" the patient really has. May as well give em nothing and hope it just resolves on its own (which is basically what you are doing anyway).

 

[Meibomian SxN]

ophtho question --

for acute nonpainful supporative conjunctivitis, I saw an ER doctor prescribe erithromycin ointment and prednisolone drops. i've heard steroids in the presence of eye infections can be a touchy subject. On the one hand, if it's bacterial, supposedly the erythromycin is broad enough to cover the infection and the steroids will cut back on inflammation (what if it's nosocomial? does that make a difference in virulence/abx coverage?). On the other hand, if it's viral, the steroids will cause immunosuppression without any aid to kill the causative agent.

is this something that is commonly done, adding steroids? Does it add any benefit to decreasing the length of illness or is it just to ease the irritation?

thanks

PS - on a side note, can you use bacitracin ointment (2nd line rx behind erythro) that you find in the hospital, you know for abrasions and such, instead of the ophthalmic bacitracin ointment? Is there really any difference? Maybe mix it with some vaseline if there's a concetration discrepency?

thanks again

Topical Bleach might do the trick but I don't suggest that 😱😀

 

[cme2c]

Topical Bleach might do the trick but I don't suggest that 😱😀

You're not too far off. I recommend Boric Acid drops for most of my conjunctivitis patients.