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Bacterial conjunctivitis - External and Internal Eye
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Bacterial conjunctivitis - External and Internal Eye

Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed


Bacterial conjunctivitis is much less common than viral or allergic conjunctivitis in adults. Children and people with chronic ocular conditions tend to be more prone to bacterial conjunctivitis.

Patients will typically complain of ocular irritation, redness, foreign body sensation, and tearing associated with increased discharge. Itching is less common in bacterial conjunctivitis.

Inoculation of the conjunctiva is usually by direct hand-eye contact or can be due to direct spread of organisms located in the patient's own nasal passageway or sinuses. Often, patients will have concurrent sinus disease, upper respiratory infection (URI), or infectious dacryocystitis (infection of the lacrimal sac).

The onset of symptoms is usually over days to weeks but can be as short as 24 hours (hyperacute) or as long as years (chronic conjunctivitis). Hyperacute conjunctivitis is typically caused by Neisseria gonorrhoeae, and chronic conjunctivitis is typically caused by Chlamydia trachomatis or Staphylococcus associated with blepharitis. Acute forms of bacterial conjunctivitis are the most common manifestations associated with the diagnosis.

Note: Per January 20, 2023, the Centers for Disease Control and Prevention (CDC) is investigating a multistate cluster of carbapenem-resistant Pseudomonas aeruginosa with Verona integron-mediated metallo-β-lactamase and Guiana extended-spectrum-β-lactamase (VIM-GES-CRPA). As of March 14, 2023, the CDC identified 68 patients in 16 states with with VIM-GES-CRPA. At this time, CDC and FDA recommend clinicians and patients stop using EzriCare or Delsam Pharma's Artificial Tears products. The isolates have remained cefiderocol sensitive.


H10.89 – Other conjunctivitis

128350005 – Bacterial conjunctivitis

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Last Reviewed:08/25/2019
Last Updated:04/09/2023
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Patient Information for Bacterial conjunctivitis - External and Internal Eye
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Contributors: Medical staff writer


Conjunctivitis is an inflammation of the tissue on the surface of the eye and/or the inside lining of the eyelids. The more common causes of conjunctivitis include:
  • Infection (viruses, bacteria)
  • Inflammatory causes such as chemicals, fumes, dust, and debris
  • Allergies
  • Injuries
  • Oral-genital contact with someone who might be infected with a sexually transmitted disease (STD) such as chlamydia, gonorrhea, or herpes
Most people consider the term "pink eye" to imply the viral type of infection.

Who’s At Risk

Conjunctivitis is very common all over the world. Nearly all people have a form of it at one time or another. Age, sex, ethnicity, and race play no role in who becomes infected. Following good hand-washing hygiene will decrease your chances of getting conjunctivitis.

Signs & Symptoms

The eye is usually pink to red with an irritated appearance. There may or may not be a discharge (tears, mucous, or pus), and there may be sensitivity to bright light. There may be burning, itching, a sandy or gravely feeling, and even pain. The lids may be stuck together in the morning upon waking. Vision might be blurred by the mucous or excess tears in the eye(s).

Self-Care Guidelines

  • Wash hands frequently so as not to contaminate others or reinfect yourself.
  • Separate your towels and washcloths so that others will not be at risk.
  • If itching is the most irritating feature, apply cold compresses.
  • If swelling is bothersome, apply cold compresses.
  • If there is a lot of discharge, especially if mucous-like, use warm compresses.
  • If there is aching and/or pain, use warm compresses.
  • Wash the eyelids very gently and soak off debris; do not pick at it.
  • Never rub the eyes, as this can spread the problem.
  • Do not share contact lens paraphernalia if you or another person is affected.

When to Seek Medical Care

  • Pain is increasing.
  • Vision is worsening.
  • There is blistering and/or rash on the eyelids.
  • Swelling is increasing.
  • There is a lot of thick mucous secreting.
  • The condition is not getting better within a week.
Note: Thick, pus-laden discharge may be from a possible blinding form of conjunctivitis and requires urgent medical care.


Topical antibiotic, anti-inflammatory, and anti-allergy drops may all be prescribed by your doctor. If the conjunctivitis is recurring frequently, oral antibiotics may be prescribed. If the conjunctivitis is related to another disease elsewhere in the body (such as a respiratory disease or an STD), that disease will need treatment as well.
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Bacterial conjunctivitis - External and Internal Eye
A medical illustration showing key findings of Bacterial conjunctivitis : Eye irritation, Conjunctival injection, Excessive tearing, Mucopurulent eye discharge
Clinical image of Bacterial conjunctivitis - imageId=3193157. Click to open in gallery.
Copyright © 2023 VisualDx®. All rights reserved.