Treat only if severe, as most viral or self-limiting.

Bacterial conjunctivitis is usually unilateral and also self-limiting; it is characterised by red eye with mucopurulent, not watery, discharge; 65% resolve on placebo by day five – consider offering delayed prescription.

Fusidic acid has less Gram-negative activity but would be preferred option in pregnancy.

Remove contact lenses until all symptoms and signs of infection resolved and treatment complete for 24 hours.

If severechloramphenicol 0.5% drop


2 hourly for 2 days then reduce frequency as infection controlled

For 48 hours after resolution

and/or chloramphenicol 1% ointment

at night only if using drops during day or 3-4 times daily if used alone

For 48 hours after resolution

Second line: fusidic acid 1% gel

Twice Daily

For 48 hours after resolution

Viral Conjunctivitis: Aciclovir 3% eye ointment

Five times daily

For 48 hours after resolution