I have a bacterial eye infection. What is the treatment of choice?

Are you sure it is a bacterial eye infection?

Both bacterial and viral eye infections are contagious (usually from person to person). The only way to tell the difference between bacterial and viral eye infections is an eye exam from an ophthalmologist.

Most eye infections are viral, and are very infectious.

Bacterial eye infections are less common and are treated with antibiotic drops and pills, and treatment of the underlying cause, such as chronic blepharitis or lid infection.

Viral eye infections are treated with artificial tears, mild steroid drops, and drops to prevent redness and itching. Special care is necessary to avoid giving the infection to others, including careful hand washing, throwing away eye make-up and contaminated contact lenses, and trying not to rub the eyes.

Be careful of "persistent" or "chronic" eye infections — they may be something else entirely, such as chronic inflammation from blepharitis or dry eye.

Don't stay on steroid drops for more than a few weeks. I just saw a patient who had been treated with steroid eye drops for a chronic lid infection from his primary care doctor. The patient wasn't getting better, so he kept re-filling the prescription, and after six weeks of (ineffective) treatment, he had steroid induced glaucoma in both eyes (and a stye which wouldn't go away).


This question was originally answered on April 4, 2013.