In children, the number of bacterial conjunctivitis cases is similar to that of viral conjunctivitis cases, but in adults, 80% of cases of infectious conjunctivitis are viral in origin.
Most cases of acute bacterial conjunctivitis resolve in 2 to 7 days without treatment. Some prospective studies suggest that delaying treatment until day 3 or 4 would significantly reduce the unnecessary use of antibiotics without affecting outcomes. However, treatment may be necessary in cases with persistent or worsening signs.
American Academy of Ophthalmology (AAO) practice guidelines recommend that initial cultures be obtained for patients with central, deep stromal, or large (>2 mm) corneal infiltrates and for patients whose history or clinical features suggest fungal, amebic, mycobacterial, or drug-resistant organisms as the causative agents.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.