11.3 Anti-infective eye preparations
Most acute (ocular surface) superficial eye infections can be treated topically. Blepharitis and conjunctivitis are often caused by staphylococci; keratitis by virus, bacteria or fungus, and occasionally protozoal and endophthalmitis may be bacterial, or fungal.
Bacterial blepharitis/Meibomitis is treated by lid hygiene and rarely by application of an antibacterial eye drops/ointment to the conjunctival sac or to the lid margins. Systemic treatment may occasionally be required and is usually undertaken after culturing organisms from the lid margin and determining their antimicrobial sensitivity; treatment for 3 months or longer may be appropriate.
Bacterial Conjunctivitis most cases of acute bacterial conjunctivitis are self-limiting; where treatment is appropriate, antibacterial eye drops or an eye ointment are used. A poor response might indicate viral or allergic conjunctivitis, or partial sensitivity-reaction to the drops, or their preservative.
Gonococcal conjunctivitis is treated with systemic and topical antibacterials (contact ophthalmologist on-call). This is a subtype of bacterial conjunctivitis.
Corneal ulcer or keratitis require specialist treatment (contact ophthalmologist on-call), usually under in-patient care, and may call for intensive topical, subconjunctival, and systemic administration of antimicrobials and mydriatics.
Endophthalmitis is a medical emergency which also calls for specialist management (contact ophthalmologist on-call) and often requires parenteral, subconjunctival, and intra-ocular administration of antimicrobials.