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Swift diagnosis, treatment of conjunctivitis helps quell patients’ fears
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Few eye conditions have as high of public recognition – and notoriety – as that of conjunctivitis.
It affects 6 million Americans each year (Udeh), with associated direct and indirect costs in the range of $370 million to $875 million (Smith). Not only is it a concern in the eyes of our patients (no pun intended), it’s a drain on health care resources, as an estimated 70% of these patients flock to their primary care physician or urgent care center (Kaufman).
To us, conjunctivitis isn’t such a big deal. After all, the vast majority are self-limiting, resolve on their own and do so without sequelae. Our patients, however, see it a bit differently. For them, conjunctivitis can be annoying – if not downright painful. It’s an inconvenience, often resulting in time away from school or work. It’s stigmatic, as no one wants to get too close to the guy with pink eye. And, perhaps, most importantly, it can be frightening, as many fear conjunctivitis symptoms are a segue to permanent blindness. While this might seem a bit alarmist, we should be mindful of the fact that permanent vision loss associated with a contact lens-related bacterial ulcer, herpes zoster ophthalmicus or a nasty adenoviral infection all – initially – started with conjunctivitis symptoms. It’s understandable why our conjunctivitis patients are often anxious and in search of answers – now.
The problem, of course, is that we do not always have answers. At least not immediately. The reality is many forms of conjunctivitis – infectious and non-infectious – offer up the same confusing array of symptoms. Redness, crusting, discharge, irritation, itching and variable vision often present to varying degrees regardless of the etiology. Compounding the issue, at least in the early stages, is that the examination often fails to reveal a pathognomonic diagnostic sign. Getting it right, of course, is critical in prescribing the proper treatment – a consideration that has become paramount in an age in which we continually balance our patients’ desire to get better now with our obligation to practice prudent antibiotic stewardship. Simply put, we should prescribe what is needed, when it’s needed, but not a drop more.
Fortunately, optometry is well suited for the task at hand. We’re well positioned to mitigate infection, whether counseling a contact lens wearer on proper lens case hygiene or an over-50-year-old on the merits of shingles vaccination. We’re accessible – a fact we should constantly remind both our patients and primary care/urgent care colleagues of, as early intervention is the first step toward recovery. Most importantly, we have the skill set to differentially diagnose and prescribe the appropriate treatment protocol, protocols that can lean more heavily on education than on eye drops. Yet, despite being so well equipped, we never lose sight of the fact that conjunctivitis can be tricky.
In this month’s feature article, “ODs pursue the latest treatments for conjunctivitis, shingles,” we’ve asked an exceptional group of colleagues to share their wealth of knowledge and experience in all things conjunctivitis. I’m confident you’ll find their suggestions scientifically sound, contemporary and clinically relevant. Most importantly, I’m sure you’ll find their advice on task for helping our patients get better – now.
- References:
- Kaufman HE. Curr Opin Ophthalmol. 2011;doi:10.1097/ICU.0b013e3283477cb5.
- Smith AF, et al. BMC Ophthalmology. 2009;doi.org/10.1186/1471-2415-9-13.
- Udeh BL, et al. Am J Med Sci. 2008;doi:10.1097/MAJ.0b013e3181637417.