HEAD, EYE, EAR, NOSE, AND THROATEMERGENCIESSYMPTOMS/EXAM
■ Redness or injection of the conjunctiva
■ Eyelash “matting”
■ Mucopurulent discharge that reaccumulates rapidly (see Figure 14.29)
■ Normal visual acuity and pupillary response
■ Clear cornea and quiet anterior chamber
■ Rapid response to topical antibiotics
TREATMENT
■ Gram stain and culture
■ Antibiotic drops or ointment
■ Warm compresses
Neisseria GonorrheaConjunctivitis
■ Rapid progression can result in corneal perforation, making this an ocular
emergency (see Figure 14.30).
■ Occurs in newborns and sexually active adults
■ Incubation 2–5 days (neonates 3–5 days after vaginal delivery)
■ Self-inoculation: Touching eye with hand after sexual contact
SYMPTOMS/EXAM
■ Hyperacute onset of symptoms
■ Copious purulent discharge
■ Chemosis (conjunctival edema)
■ Preauricular adenopathy
TREATMENT
■ Gram stain and culture
■ Parenteral and topical coverage:
■ Ceftriaxone 1 g IM/IV QD ×7 days
■ Topical antibiotic ointment
■ Cover for chlamydia with PO doxycycline or erythromycin
FIGURE 14.29. Bacterial conjunctivitis.
(Courtesy of Frank Birinyi, MD as published in Knoop KJ, Stack LB, Storrow AB. Atlas of
Emergency Medicine,2nd ed. New York: McGraw-Hill, 2002:30.)