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Hyperacute Bacterial Conjunctivitis
IM and PO
Ceftriaxone 1g IM (125mg ped) x5d (x2d ped)
Spectromycin 2g IM
Azithromycin 1000mg PO, 1 dose
Amoxicillin 3g PO
Ampicillin 3.5g PO
Procaine G Penicillin 4.8-9.6mil units + Probenecid 1g


Hyperacute Bacterial Conjunctivitis
Topical
Fluoroquinolone 3rd/4th gen Q2H
Bacitracin/Erythromycin QID (ped)
Hyperacute Bacterial Conjunctivitis
w/ (+) Chlamydia
Tetracycline/Erythromycin 250-500mg PO QID x2-3wk

Doxycycline 100mg PO BID x2-3wk
Acute Staph/Strep Conjunctivitis
Topical Fluoroquinolone (3rd/4th TID Staph, 4th Strep)
Topical Azithromycin BID
Bacitracin UNG QHS (or QID for kids as primary Tx)
Acute H. Flu Conjunctivitis
Topical Fluoroquinolone 4th QID
Topical Azithromycin BID
Bacitracin UNG QHS
Amoxicillin/Clavulanate PO 20-40mg/kg/day
Blepharitis

Antibiotic UNG Tx
Neosporin
Polysporin
Erythromycin
Aminoglycoside
Blepharitis

Antibiotic PO Tx
Dicloxacillin 250 QIDx10d
Tetracycline 250-500 QIDx10d
Erythromycin 250-500 QIDx10d
EES 400-800 QID
Allergic Conjunctivitis
Histamine Interruption
Naphcon-A
Opcon-A
Vasocon-A
-all TID-QID

Benadryl
Claritin
Zyrtec
Allegra (Fexofenadine)
Allergic Conjunctivitis
H1 Antagonist
Emadine - prophylaxis
Allergic Conjunctivitis
Mast Cell Stabilizer
Alomide (Iodoxamide) QID
Cromolyn (Crolom) QID
Alocril (Nedocromil) BID
Allergic Conjunctivitis
MS Stabilizer + Antihistamine
Pataday QD
Patanol BID
Zaditor BID
Optivar BID
Elestat BID
Bepreve BID
Allergic Conjunctivitis
NSAIDs
Ketorolac (Acular)
Diclofenac (Voltaren)
Allergic Conjunctivitis
Steroids
Pred Mild
FML
HMS
Alrex

TID-QID only for a few days
Vernal Conjunctivitis
Mass Cell Stabilizer
Alomide (Iodoxamide) QIDx3mo
Crolom (Cromolyn) QIDx3mo
Patanol BID
Vernal Conjunctivitis
Steroids
Prednisolone
FML/Lotemax for glaucoma pt.s

Keep at Q2H for 3 days, then Q4H for 4 days.
Vernal Conjunctivitis
Antihistamines
Naphcon-A QID
Opcon-A QID
Vasocon-A QID
Levocabastine - H1 antagonist
Phlyctenules
Steroids
1% Prednisolone
0.5% Lotemax
0.1% FML

Q2Hx3-4d, taper to QIDx3d
Phlyctenules
Antibiotics
Gentamicin/Norfloxacin/Ofloxacin QID
Maxitrol
Pred-G
Tobradex

Tetracycline/Doxy/Azithro
250 PO TIDx3wk
Environmental Conjunctivitis
Unpreserved ATs
Oxymetazoline (Ocuclear)
Naphazoline (Degest)
Tetrahydrozoline (Visine)
Primary Herpes Simplex
No Keratitis
Aminoglycoside QID
Fluoroquinolones QID
Polytrim QID

Vasoconstrictors: oxymetazoline, naphazoline, tetrahydrozoline
Primary Herpes Simplex
If only SPK present
Trifluridine (Viroptic) QID
Vidarabine (Vira A) UNG in kids
Acyclovir (Zovirax) 200mg/5mL
Vasoconstrictors
Primary Herpes Simplex
If dendrites are present
Trifluridine (Viroptic) Q2Hx1wk
Vidarabine (Vira A) Q2Hx1wk

Acyclovir (Zovirax) PO if lesion is resistant or pt. is immunocompetent.
Primary Herpes
Natural Approach
L- Lysine 500 mg BID,  3g for active infection

Super B Complex Vitamins – Reduce duration and recovery of vesicles
Herpes Zoster Conjunctivitis
For conjunctivitis
Vasoconstrictors
Lubes
Cool compresses
Aminoglycosides
Fluoroquinolone
Herpes Zoster Conjunctivitis
For immunocompetent pt.
Acyclovir (Zovirax) 800 PIDx7d
Famcyclovir (Famvir) 500 TIDx7d
Valacyclovir (Valtrex) 1g TIDx7d

Topical capsaicin 0.025%
Amitryptyline 25mg TID
Perphenazine 4mg TID
Fluphenazine 1mg QID
Epidemic Keratoconjunctivitis
For moderate/severe EKC
1gtt Proparacaine
2gtt Betadine
Pt. rolls eyes, then clean lids with Betadine soaked Q-tip.
Rinse eyes with saline

Topical Pred Forte QID to reduce inflam.
Epidemic Keratoconjunctivitis
EKC + 2ndary Bacterial Conjunctivitis
Aminoglycoside/Fluoroquinolone DAY
Polysporin NIGHT
Epidemic Keratoconjunctivitis
Steroid Use
Q2Hx1d
QIDx4d
BIDx4d

Only use if:
Pseudomembrane present
SEI are debilitating to vision
VAs of 20/40 to 20/60
Pharyngoconjunctival Fever
Palliative Therapy
Lubricants
ATs
Vasoconstrictors
Cool Compresses
Tylenol
Betadine Disinfection
Aminoglycoside/FQ for 2ndary bacterial infection
Rubeola (Red Measles) Conjunctivitis
Lubricants
ATs
Vasoconstrictors
Tylenol
Aminoglycoside/FQ QID for keratitis
Oculoglandular Syndrome
Cat Scratch
Erythromycin 250 QIDx4-8wk
Azithromycin 250 QIDx4-8wk
Polysporin QIDx2wk
Erythromycin QIDx2wk
Tetracycline QIDx2wk
Oculoglandular Syndrome
Tularemia
Streptomycin 1g IMx7d
Gentamicin 2g/day
Tetracycline 2g/day

Gentamicin Q2Hx7d
Oculoglandular Syndrome
Tuberculosis
Streptomycin STM S
Isoniazid INH H
Rifampicin RMP R
Ethambutol EMB E
Pyrazinamide PZA Z
Oculoglandular Syndrome
Syphilis
Penicillin G 4.8mil
Doxy 100 BIDx15d
Minocycline 100 BIDx15d
Tetracycline 500 QIDx15d
Oculoglandular Syndrome
Sporotrichosis
Local - Potassium Iodide
Systemic - Ketoconazole, Itraconazole, Fluconazole
Oculoglandular Syndrome
Coccidioidomycosis
Amphotericin B
Ketoconazole
Oculoglandular Syndrome
Actinomycosis
Oral penicillin/erythromycin
Oculoglandular Syndrome
Lymphogranuloma Venereum
Tetracycline/Doxy 2-6wk
Oculoglandular Syndrome
Ocular therapy
Gentamicin UNG Q2-3hx2d
Tobramycin UNG Q2-3hx2d
Bacitracin UNG Q2-3hx2d

FQ drops
Toxic Conjunctivitis
Prednisolone sodium phosphate 0.12% (Inflamase Mild)
HMS

BID or qD
Chlamydial Dz
Trachoma
PO Tx
Doxycycline/Minocycline 50-100 BIDx4wk
Tetracycline 250-500 BIDx4wk
Erythromycin 500 QIDx4wk
Triple Sulfa for those tetra resistance.
Chlamydial Dz
Trachoma
UNG Tx
Tetracycline UNG BIDx6-8wk
Erythromycin UNG BIDx6-8wk
Azithromycin UNG BIDx4wk
Inclusion Conjunctivitis
Tetracycline 250-500 QIDx3wk (no Ca, Mg, Fe)

Doxycycline 50-100 BIDx3wk (100mg loading dose BIDx1d, 50mg BID after)(take with Ca)

Erythromycin 500 QIDx3wk
EES 800 QIDx3wk
Azithromycin 1000 single (>16yo)

Neonates
Tetracycline UNG BIDx2-3wk
Erythromycin UNG BIDx2-3wk
Erythromycin 40mg/kg/day x2-3wk
Facial Rosacea
Tetracycline 250 QIDx8wk, then taper
Doxycyccline 50-100 BIDx8wk
Metrogel
Ocular Rosacea
FML
Prednisolone acetate 0.12%
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