33 yo female presents today for a recheck on right eye irritation x 5 days. Pt was seen 2 days prior and disgnoised with bacterial conjunctivitis and given Gentamicin drops. Pt states that she has been having right eye irritation with mild pain, slightly blurred vision, lid erythema with mild edema, excessive tearing, puruitis, headache. Noted on exam mild papillary reaction, hyperemia, mild photophobia, right sided perauricular lymphadneopathy, mild chemosis. Vision: OD: 20/30 OS: 20/40. Pt states that she feels like she is starting to get symptoms on the left side as well. No foreign bodies seen on lid eversion. No defects noted on fluroscene stain. Rest of exam normal. No PMHx no other current medications. No contact lenses. DDX? Tests? Tmt?

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AUte adenoviral conjunctivitis . Rx : - tobramycin e/drops 1 & half hrly. - chloramphenicol with polymyxin with dexamethasone e drops 3hrly. - short acting cycloplegic x 2 days. - Tab. Paracetamol tid x 7 days. Dark glasses.

Adenoviral Conjunctivitis, Gancyclovir may act on adenovirus on higher concentration so give Gancyclovir gel TDS, Lubricants eye drops QID, Antiallergic vasoconstrictor eye drop QID, since Adenoviral Conjunctivitis has late immunological activity topical steroid + antibiotic cover TDS or BD can be added. Antibiotic ointment for night to prevent sticking of lashes of both lids

This is most likely an adenoviral keratoconjunctivitis which starts unilaterally and becomes bilateral in course of 7 days or so.

Conjunctivitis

Antibiotic eye drop qid Lubricating eye drop frequently Mezol eye drop qid Ointment if required Mild steroid with anti biotic cover Analgesic tab

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