![](media/image1.png){width="5.96875in" height="0.41944444444444445in"}

Top of Form

## Complete Summary

#### GUIDELINE TITLE

Care of the patient with conjunctivitis. 2nd edition.

#### BIBLIOGRAPHIC SOURCE(S)

American Optometric Association. Care of the patient with
conjunctivitis. 2nd ed. St. Louis (MO): American Optometric Association;
2002 Nov 8. 55 p. \[80 references\]

#### GUIDELINE STATUS

This is the current release of the guideline.

This guideline updates a previously published version: Care of the
patient with conjunctivitis. St. Louis (MO): American Optometric
Association; 1995. 54 p.

According to the guideline developer, this guideline has been reviewed
on a biannual basis and is considered to be current. This review process
involves updated literature searches of electronic databases and expert
panel review of new evidence that has emerged since the original
publication date.

### \*\* REGULATORY ALERT \*\*

#### FDA WARNING/REGULATORY ALERT

**Note from the National Guideline Clearinghouse**: This guideline
references a drug(s) for which important revised regulatory and/or
warning information has been released.

-   [September 11, 2007, Rocephin (ceftriaxone
    sodium)](http://www.fda.gov/medwatch/safety/2007/safety07.htm#Rocephin):
    Roche informed healthcare professionals about revisions made to the
    prescribing information for Rocephin to clarify the potential risk
    associated with concomitant use of Rocephin with calcium or
    calcium-containing solutions or products.

### COMPLETE SUMMARY CONTENT

 \*\* REGULATORY ALERT \*\*\
 SCOPE\
 METHODOLOGY - including Rating Scheme and Cost Analysis\
 RECOMMENDATIONS\
 EVIDENCE SUPPORTING THE RECOMMENDATIONS\
 BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS\
 QUALIFYING STATEMENTS\
 IMPLEMENTATION OF THE GUIDELINE\
 INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT
CATEGORIES\
 IDENTIFYING INFORMATION AND AVAILABILITY\
 DISCLAIMER

### SCOPE

#### DISEASE/CONDITION(S)

Conjunctivitis, including the following types:

-   Allergic conjunctivitis (atopic keratoconjunctivitis, simple
    allergic conjunctivitis, seasonal conjunctivitis, vernal
    conjunctivitis, giant papillary conjunctivitis)

-   Bacterial conjunctivitis (hyperacute, acute, chronic)

-   Viral conjunctivitis (adenoviral, herpetic)

-   Chlamydial conjunctivitis

-   Other forms of conjunctivitis (contact lens-related, mechanical,
    traumatic, toxic, neonatal, Parinaud\'s oculoglandular syndrome,
    phlyctenular, secondary)

#### GUIDELINE CATEGORY

Diagnosis\
Evaluation\
Management\
Treatment

#### CLINICAL SPECIALTY

Optometry

#### INTENDED USERS

Health Plans\
Optometrists

#### GUIDELINE OBJECTIVE(S)

-   To identify patients at risk of developing conjunctivitis

-   To accurately diagnose conjunctivitis of diverse origins

-   To improve the quality of care rendered to patients with
    conjunctivitis

-   To initiate appropriate treatment for conjunctivitis

-   To reduce the potentially adverse effects of conjunctivitis

-   To inform and educate patients and other health care practitioners
    about the diagnosis, treatment, and management of conjunctivitis.

#### TARGET POPULATION

Patients with suspected or diagnosed conjunctivitis

#### INTERVENTIONS AND PRACTICES CONSIDERED

**Diagnosis**

1.  Patient history

2.  Ocular examination

    -   Visual acuity

    -   Neuro-ophthalmic screening

    -   External examination

    -   Biomicroscopy

    -   Tonometry

    -   Fundus examination

3.  Supplemental testing

    -   Cultures, smears, and scrapings

    -   Immunoassay

    -   Conjunctival biopsy

**Management**

1.  Identify and remove causative antigen or organism

2.  Supportive therapy (nonpreserved lubricants, cold compresses)

3.  Appropriate regimen of pharmacologic agents, depending on the
    etiology

4.  Co-management with physician for treatment of underlying ocular or
    systemic condition

5.  Patient counseling and education regarding condition and proper
    hygiene

#### MAJOR OUTCOMES CONSIDERED

Not stated

### METHODOLOGY

#### METHODS USED TO COLLECT/SELECT EVIDENCE

Hand-searches of Published Literature (Primary Sources)\
Searches of Electronic Databases

#### DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE

The guideline developer performed literature searches using the National
Library of Medicine\'s Medline database and the VisionNet database.

#### NUMBER OF SOURCE DOCUMENTS

Not stated

#### METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE

Expert Consensus (Committee)

#### RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE

Not applicable

#### METHODS USED TO ANALYZE THE EVIDENCE

Review

#### DESCRIPTION OF THE METHODS USED TO ANALYZE THE EVIDENCE

Not applicable

#### METHODS USED TO FORMULATE THE RECOMMENDATIONS

Not stated

#### RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS

Not applicable

#### COST ANALYSIS

A formal cost analysis was not performed and published cost analyses
were not reviewed.

#### METHOD OF GUIDELINE VALIDATION

Internal Peer Review

#### DESCRIPTION OF METHOD OF GUIDELINE VALIDATION

The Reference Guide for Clinicians was reviewed by the American
Optometric Association (AOA) Clinical Guidelines Coordinating Committee
and approved by the AOA Board of Trustees.

### RECOMMENDATIONS

#### MAJOR RECOMMENDATIONS

A.  **Diagnosis of Conjunctivitis**

> A detailed examination should be performed on patients presenting with
> acute or chronic conjunctivitis. Additional testing to diagnose
> routine cases of conjunctivitis is generally not necessary. A
> comprehensive eye examination with dilation of the pupil should be
> performed in those patients with conjunctival hyperemia accompanied by
> proptosis, optic nerve dysfunction, decreased visual acuity, diplopia,
> or evidence of anterior chamber inflammation. In addition, visual
> field testing may be indicated for these patients.

1.  Patient History

> The diversity of etiologies for conjunctivitis makes a detailed
> patient history the most important step in the differential diagnosis
> of conjunctivitis. The patient history includes the chief complaint,
> ocular history, general health history and review of systems, social
> history, and family ocular and medical history (see Table 3 in the
> original guideline document).

2.  Ocular Examination

> The ocular examination may include, but is not limited to, the
> following procedures:

-   *Visual acuity*: Documentation of baseline best corrected visual
    acuity is standard practice.

-   *Neuro-ophthalmic screening*: Pupillary responses, confrontation
    visual fields, and extraocular motility should be evaluated in
    patients with conjunctivitis because several important ophthalmic
    disorders can masquerade as conjunctivitis.

-   *External examination*: Successful diagnosis of conjunctivitis
    requires complete examination of the external eye and regional
    anatomy. Table 4 in the original guideline document lists the
    important components and relevant clinical findings of the external
    examination.

-   *Biomicroscopy*: Careful biomicroscopy should be performed on all
    patients with conjunctivitis. Table 5 in the original guideline
    document lists the important biomicroscopic clinical observations in
    diagnosing patients with conjunctivitis.

-   *Tonometry*: In cases that have clinical evidence of infectious
    conjunctivitis but no evidence of acute angle closure glaucoma or
    prior history of glaucoma, tonometry may be deferred until a
    follow-up examination.

-   *Fundus examination*: Fundus evaluation is recommended for all
    patients with conjunctivitis. Dilated fundus examination is not
    required at the presenting examination unless specifically
    indicated.

3.  Supplemental testing, such as:

    -   *Cultures, smears, and scrapings*: Conjunctival cultures and
        smears or scrapings should be obtained in cases of chronic,
        neonatal, hyperacute, or recurrent conjunctivitis. They should
        also be considered for cases in which acute conjunctivitis is
        unresponsive to treatment and for immunocompromised patients.
        Appendix Figure 2 in the original guideline document describes
        procedures for obtaining conjunctival cultures, smears, and
        scrapings.

> Hyperacute conjunctivitis has the potential for serious and blinding
> complications. Identification of the etiologic agent and determination
> of antibiotic sensitivities are essential for proper management.
> Cultures, smears, and scrapings, which should be obtained prior to
> beginning treatment, can help guide the selection of the initial
> treatment regime.

-   *Immunoassay*: Direct fluorescein-conjugated monoclonal antibody
    tests are used to detect chlamydial antigens in conjunctival
    scrapings.

-   *Conjunctival biopsy*: Conjunctival biopsy is occasionally useful in
    refractory or atypical conjunctivitis and is mandatory in cases of
    suspected neoplasm.

B.  **Management of Conjunctivitis**

    1.  Available Treatment Options

        -   *Allergic Conjunctivitis*

> Treatment of allergic conjunctivitis is based upon identification and
> elimination of specific antigens, when practical, and upon the use of
> medications that decrease or mediate the immune response. The use of
> supportive treatment, including nonpreserved lubricants and cold
> compresses, may provide symptomatic relief. A variety of pharmacologic
> agents, listed below and described in greater detail in the guideline
> document, may be useful in treating allergic conjunctivitis:

-   Topical steroids

-   Topical vasoconstrictor/antihistamines

-   Topical antihistamine

-   Topical nonsteroidal anti-inflammatory drugs

-   Topical mast-cell stabilizers

-   Agents with multiple mechanisms of action

-   Immunosuppressants

-   Systemic antihistamines

```{=html}
<!-- -->
```
-   *Bacterial Conjunctivitis*

> The ideal method of treating bacterial conjunctivitis is to identify
> the causative organism and initiate the specific antimicrobial
> treatment known to be effective against the offending organism. Table
> 7 in the original guideline document lists the commonly available
> topical antimicrobial drugs, their spectrum of activity, and drug
> dosage recommendations. In the absence of a culture or smear, the
> etiologic agent should be considered with respect to the patient\'s
> age, environment, and related ocular findings. In most cases,
> broad-spectrum topical antibiotics are the treatment of choice.
> Although most cases of bacterial conjunctivitis are self-limiting,
> treatment with antibiotics can lessen the patient\'s symptoms and the
> duration and chances of recurrence of the disease.
>
> Hyperacute conjunctivitis requires special consideration because of
> potential blinding from inadequately treated gonococcal infections.
> Conjunctival smears and cultures should be obtained before beginning
> treatment. The administration of systemic antibiotics that are
> effective against the identified organisms should be started
> immediately. Saline lavage may be beneficial in removing purulent
> discharge. In the case of gonococcal infection, the Centers for
> Disease Control and Prevention (CDC) recommends the administration of
> a single dose of intramuscular ceftriaxone. Although the CDC does not
> recommend topical treatment, practitioners may wish to consider the
> addition of a topical fluoroquinolone as adjunctive therapy. Patients
> should also be evaluated for co-infection with other sexually
> transmitted diseases. Care of the patient with sexually transmitted
> disease should be coordinated with the patient\'s primary care
> physician.

-   *Viral Conjunctivitis*

> Supportive therapy for adenoviral infection includes the time-honored
> treatment options: cold compresses, lubricants, and ocular
> decongestants.
>
> Topical antibiotics are not routinely used to treat viral
> conjunctivitis unless there is evidence of secondary bacterial
> infection. The risk of toxic and allergic reactions may outweigh the
> potential benefit of antibiotic use. The use of steroids in the
> management of adenoviral conjunctivitis remains controversial. Because
> of the potential side effects of topical ophthalmic corticosteroids,
> practitioners may wish to limit the use of these agents to patients
> who are significantly symptomatic or who develop visual loss from
> inflammatory keratitis.
>
> The treatment of herpes simplex conjunctivitis may include the use of
> antiviral agents such as trifluridine, although there is no evidence
> that this therapy results in a lower incidence of recurrent disease or
> keratitis. Supportive therapy, including lubricants and cold
> compresses, which may be as effective as antiviral drugs, eliminates
> the potential for toxic side effects. Topical steroids are
> specifically contraindicated for treating herpes simplex
> conjunctivitis.
>
> Herpes zoster conjunctivitis treatment includes the use of topical
> antibiotic/steroid combinations to reduce the risk of secondary
> bacterial infection and decrease the inflammatory response. In
> contrast to their effect on herpes simplex infections, topical
> steroids do not exacerbate herpes zoster infections. In addition to
> topical therapy, systemic antiviral treatment reduces the duration of
> both viral shedding and post-herpetic neuralgia. To be most effective
> in reducing the duration of post-herpetic neuralgia, systemic
> antiviral therapy should be started within 72 hours of the first signs
> of herpes zoster infection.

-   *Chlamydial Conjunctivitis*

> The primary treatment for adult inclusion conjunctivitis is systemic
> antibiotics; topical therapy alone is inadequate. The recommended
> systemic treatment, based on the patient\'s age, weight, and medical
> history, is either of two equally efficacious options: a single dose
> of azithromycin 1 g or doxycycline 100 mg twice daily for 7 days.
> Azithromycin is the preferred treatment, especially when patient
> compliance is a potential problem. Patients\' sexual partners should
> also be evaluated for the presence of the infection, and treatment
> should be initiated as indicated. In cases of chlamydial infection
> affecting preadolescent children, the clinician should consider the
> possibility that sexual abuse has occurred.

-   *Contact Lens-Related Conjunctivitis*

> The primary treatment of contact lens-related conjunctivitis involves
> discontinuing contact lens wear and determining the underlying
> etiologic mechanism for the conjunctivitis. Solution allergies,
> hypoxic conditions, giant papillary conjunctivitis (GPC), bacterial
> infections, or contact lens-related trauma should be identified and
> corrected prior to resuming contact lens wear.

-   *Mechanical Conjunctivitis*

> Removal of the offending trauma-inducing agent (e.g., misdirected
> lash, exposed suture) and subsequent lubrication usually constitute
> adequate treatment of mechanical conjunctivitis. In addition to
> lubricants, prophylactic broad-spectrum antibiotic ophthalmic drops
> should be considered in cases of significant epithelial disruption
> (staining) until the epithelial defects have resolved.

-   *Traumatic Conjunctivitis*

> The treatment of traumatic conjunctivitis depends upon the nature of
> the trauma. Conjunctival abrasions may be treated with topical
> antibiotics, cycloplegia, and pressure patching. Topical antibiotics
> may be used in cases of epithelial disruption, and oral analgesics
> should be prescribed for pain as needed. The initial treatment of
> chemical injuries should include copious irrigation with normal saline
> or balanced salt solution until the pH of the conjunctival cul-de-sac
> has returned to normal. Chemical injuries, particularly alkali burns,
> have the potential for significant ocular morbidity and require
> aggressive management.

-   *Toxic Conjunctivitis*

> Most cases of toxic conjunctivitis result from overuse of topical
> medications and/or cosmetics, or both. Occasionally, environmental
> exposure to noxious agents results in toxic conjunctivitis. Treatment
> involves identifying and removing the offending agent. Molluscum
> lesions on the lids should be excised. Symptomatic patients may
> benefit from using cold compresses or topical ophthalmic
> antibiotic/corticosteroid combinations, or both. The treatment of
> toxic conjunctivitis from overuse of topical preparations should be to
> stop all topical medications initially, when possible, and use
> preservative-free topical lubricants 4 to 8 times a day for 3 to 5
> days. Patients who show no sign of clinical improvement after this
> treatment should be reevaluated for another underlying cause.

-   *Neonatal Conjunctivitis*

> The optometrist should consider comanaging neonatal conjunctivitis
> with a pediatrician, neonatologist, or pediatric infectious disease
> specialist. Treatment should begin immediately upon diagnosis.
> Initially, antimicrobial therapy should be directed at the organism
> identified in conjunctival smears. The guideline document summarizes
> the current therapeutic approaches to the most common causes of
> neonatal conjunctivitis.

-   *Parinaud\'s Oculoglandular Syndrome*

> Because the vast majority of cases are self-limiting, the aim of
> therapy for Parinaud\'s oculoglandular syndrome is symptomatic relief
> of preauricular lymphadenopathy. The application of a mild topical
> vasoconstrictor/lubricant and warm soaks of the inflamed preauricular
> area are generally sufficient. Biopsy of conjunctival granuloma not
> only provides diagnostic information regarding the etiologic agent but
> may have therapeutic benefits; however, this procedure is indicated
> only in severe cases.

-   *Phlyctenular Conjunctivitis*

> The treatment of phlyctenular conjunctivitis is directed at the
> underlying mechanism, to eradicate the sensitizing agent when
> possible. This generally means eliminating chronic lid disease, which
> serves as a reservoir for *Staphylococcus aureus*. The conjunctivitis
> itself responds favorably to the topical use of an
> antibiotic/corticosteroid combination applied 4 times a day for
> several days and then tapered. When there is associated blepharitis or
> other dermatologic disorder (e.g., acne rosacea), oral doxycycline can
> be helpful. In children younger than 8 years of age or in pregnant
> women, erythromycin should be used rather than doxycycline. When the
> patient\'s history is significant for potential mycobacterium
> tuberculosis exposure, the practitioner should consider and rule out
> tuberculosis as the etiologic agent.

-   *Secondary Conjunctivitis*

> The management of secondary conjunctivitis requires identification and
> treatment of the underlying ocular or systemic conditions. Patients
> who develop conjunctivitis as a manifestation of systemic disease
> should be evaluated and comanaged with an appropriate medical
> specialist.

2.  Patient Education

> Effective management of conjunctivitis requires appropriate patient
> education. Thorough education may help relieve the patient\'s anxiety
> about the condition and increase his or her compliance with therapy.
> Good patient education is also crucial for preventing the spread of
> infectious conjunctivitis, which in many cases is highly contagious.
> The practitioner should stress the importance of frequent hand washing
> by patients and family members, of using separate linens, towels, and
> washcloths, and of avoiding direct contact with infected material or
> individuals.

3.  Prognosis and Follow-Up

> Once conjunctivitis has been diagnosed and treatment has been
> initiated, the patient requires follow-up care. The frequency of
> follow-up visits varies with the severity of the condition, the
> diversity of etiologies considered, and the potential for ocular
> morbidity. Follow-up should be designed for careful monitoring of
> disease progression and verification that the selected treatment
> regime is effective. Alteration of therapy, when needed, as well as
> recognition of adverse side effects and reevaluation of the condition
> and its response to treatment at regular intervals, are integral to
> successful patient management (see table below).

**Frequency and Composition of Evaluation and Management Visits for
Conjunctivitis**

  -----------------------------------------------------------------------------------------------------------------
  **Type of        **Frequency   **History**   **Visual   **Slit Lamp       **Ophthalmoscopy**   **Management
  Patient**        of                          Acuity**   Biomicroscopy**                        Plan**
                   Follow-Up**                                                                   
  ---------------- ------------- ------------- ---------- ----------------- -------------------- ------------------
  Allergic         Mild:\        Yes           Yes        Yes               As indicated         Identify/remove
  Conjunctivitis   every 5 to 7                                                                  allergen.\
                   days\                                                                         Prescribe
                   Moderate:\                                                                    unpreserved
                   every 3 to 5                                                                  lubricants, cold
                   days\                                                                         compresses,
                   Severe:\                                                                      topical
                   every 1 to 3                                                                  pharmaceuticals,
                   days                                                                          systemic
                                                                                                 antihistamines.\
                                                                                                 Educate patients.

  Bacterial        Mild:\        Yes           Yes        Yes               As indicated         Identify organism
  Conjunctivitis   every 5 to 7                                                                  and specific
                   days\                                                                         antimicrobial
                   Moderate:\                                                                    agent.\
                   every 3 to 5                                                                  Hyperacute form:
                   days\                                                                         obtain smears and
                   Severe -                                                                      cultures, do
                   every 1 to 3                                                                  saline lavage.\
                   days                                                                          Prescribe topical
                                                                                                 and/or systemic
                                                                                                 antibiotics.\
                                                                                                 Obtain
                                                                                                 consultation for
                                                                                                 evaluation and
                                                                                                 treatment of
                                                                                                 underlying
                                                                                                 systemic
                                                                                                 condition.\
                                                                                                 Educate patient.

  Viral            Mild:\        Yes           Yes        Yes               As indicated         Prescribe cold
  Conjunctivitis   every 5 to 7                                                                  compresses,
                   days\                                                                         lubricants, ocular
                   Moderate:\                                                                    decongestants, and
                   every 3 to 5                                                                  topical
                   days\                                                                         pharmacologic
                   Severe -                                                                      agents as
                   every 1 to 3                                                                  appropriate.\
                   days                                                                          Educate patient

  Chlamydial       Mild:\        Yes           Yes        Yes               As indicated         Prescribe systemic
  Conjunctivitis   every 5 to 7                                                                  antibiotics.\
                   days\                                                                         Obtain
                   Moderate -                                                                    consultation for
                   every 3 to 5                                                                  evaluation and
                   days\                                                                         treatment of
                   Severe -                                                                      underlying
                   every 1 to 3                                                                  systemic
                   days                                                                          condition\
                                                                                                 Educate patient
  -----------------------------------------------------------------------------------------------------------------

#### CLINICAL ALGORITHM(S)

An algorithm is provided in the original guideline document for
Optometric Management of the Patient with Conjunctivitis.

### EVIDENCE SUPPORTING THE RECOMMENDATIONS

#### TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of supporting evidence is not specifically stated for each
recommendation.

### BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS

#### POTENTIAL BENEFITS

-   Conjunctivitis is a common multifaceted disease process that has a
    variety of etiologies, clinical features, and treatments.
    Professional care is needed for accurate diagnosis and effective
    treatment. Optometrists play an integral role in the diagnosis and
    treatment of conjunctivitis.

-   Appropriate treatment for conjunctivitis may increase patient
    comfort, reduce the duration of infection, help prevent the spread
    of infection, reduce the socioeconomic cost of conjunctivitis, and
    reduce the incidence of associated adverse complications in
    untreated cases.

#### POTENTIAL HARMS

Not stated

### QUALIFYING STATEMENTS

#### QUALIFYING STATEMENTS

-   Clinicians should not rely on this Clinical Guideline alone for
    patient care and management. Please refer to the references and
    other sources listed in the original guideline for a more detailed
    analysis and discussion of research and patient care information.

-   The components of patient care described within this guideline are
    not intended to be all inclusive, because professional judgment and
    individual patient symptoms and findings may have a significant
    impact on the nature, extent, and course of the services provided.
    Some components of care may be delegated.

### IMPLEMENTATION OF THE GUIDELINE

#### DESCRIPTION OF IMPLEMENTATION STRATEGY

An implementation strategy was not provided.

#### IMPLEMENTATION TOOLS

Clinical Algorithm

For information about
[availability](#identifying-information-and-availability), see the
\"Availability of Companion Documents\" and \"Patient Resources\" fields
below.

### INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES

#### IOM CARE NEED

Getting Better\
Living with Illness

#### IOM DOMAIN

Effectiveness\
Patient-centeredness

### IDENTIFYING INFORMATION AND AVAILABILITY

#### BIBLIOGRAPHIC SOURCE(S)

American Optometric Association. Care of the patient with
conjunctivitis. 2nd ed. St. Louis (MO): American Optometric Association;
2002 Nov 8. 55 p. \[80 references\]

#### ADAPTATION

Not applicable: The guideline was not adapted from another source.

#### DATE RELEASED

1995 (revised 2002 Nov 8; reviewed 2007)

#### GUIDELINE DEVELOPER(S)

American Optometric Association - Professional Association

#### SOURCE(S) OF FUNDING

Funding was provided by the Vision Service Plan (Rancho Cordova,
California) and its subsidiary Altair Eyewear (Rancho Cordova,
California)

#### GUIDELINE COMMITTEE

American Optometric Association Consensus Panel on the Care of the
Patient with Conjunctivitis

#### COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

*Members*: Christopher J. Quinn, OD (Principal Author); Dennis E.
Mathews, OD; Richard F. Noyes, OD; Gary E. Oliver, OD; J. James Thimons,
Jr., OD; Randall K. Thomas, OD

*AOA Clinical Guidelines Coordinating Committee Members*: John C.
Townsend, OD, *Chair* (2nd Edition); John F. Amos, OD, MS (1st and 2nd
Edition); Barry Barresi, OD, PhD (1st Edition); Kerry L. Beebe, OD (1st
Edition); Jerry Cavallerano, OD, PhD (1st Edition); John Lahr, OD (1st
Edition); W. Howard McAlister, OD, MPH (2nd Edition); Stephen C. Miller,
OD (2nd Edition); David Mills, OD (1st Edition)

#### FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

#### GUIDELINE STATUS

This is the current release of the guideline.

This guideline updates a previously published version: Care of the
patient with conjunctivitis. St. Louis (MO): American Optometric
Association; 1995. 54 p.

According to the guideline developer, this guideline has been reviewed
on a biannual basis and is considered to be current. This review process
involves updated literature searches of electronic databases and expert
panel review of new evidence that has emerged since the original
publication date.

#### GUIDELINE AVAILABILITY

Electronic copies: Available in Portable Document Format (PDF) from the
[American Optometric Association Web
site.](http://www.aoa.org/documents/CPG-11.pdf)

Print copies: Available from the American Optometric Association, 243 N.
Lindbergh Blvd., St. Louis, MO 63141-7881.

#### AVAILABILITY OF COMPANION DOCUMENTS

None available

#### PATIENT RESOURCES

None available

#### NGC STATUS

This summary was completed by ECRI on December 1, 1999. The information
was verified by the guideline developer on January 31, 2000. This
summary was updated by ECRI on April 16, 2004. The information was
verified by the guideline developer on May 10, 2004. This summary was
updated by ECRI Institute on October 3, 2007 following the U.S. Food and
Drug Administration (FDA) advisory on Rocephin (ceftriaxone sodium).

#### COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to
the guideline developer\'s copyright restrictions as follows:

Copyright to the original guideline is owned by the American Optometric
Association (AOA). NGC users are free to download a single copy for
personal use. Reproduction without permission of the AOA is prohibited.
Permissions requests should be directed to Jeffrey L. Weaver, O.D.,
Director, Clinical Care Group, American Optometric Association, 243 N.
Lindbergh Blvd., St. Louis, MO 63141; (314) 991-4100, ext. 244; fax:
(314) 991-4101; e-mail: <JLWeaver@AOA.org>.

### DISCLAIMER

#### NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce,
approve, or endorse the guidelines represented on this site.

All guidelines summarized by NGC and hosted on our site are produced
under the auspices of medical specialty societies, relevant professional
associations, public or private organizations, other government
agencies, health care organizations or plans, and similar entities.

Guidelines represented on the NGC Web site are submitted by guideline
developers, and are screened solely to determine that they meet the NGC
Inclusion Criteria which may be found at
<http://www.guideline.gov/about/inclusion.aspx> .

NGC, AHRQ, and its contractor ECRI Institute make no warranties
concerning the content or clinical efficacy or effectiveness of the
clinical practice guidelines and related materials represented on this
site. Moreover, the views and opinions of developers or authors of
guidelines represented on this site do not necessarily state or reflect
those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or
hosting of guidelines in NGC may not be used for advertising or
commercial endorsement purposes.

Readers with questions regarding guideline content are directed to
contact the guideline developer.

Bottom of Form

© 1998-2008 National Guideline Clearinghouse

Date Modified: 11/10/2008