46 year old patient. 6 days history of conjunctivitis. Earlier only right eye involvement with diffuse redness over conjunctiva. Lids and conjunctiva are edematous. Left eye started showing same symptoms since yesterday. On medication K-MOXI-LP (Moxifloxacin & Loteprednol Etabonate) and Misty gel (Carboxymethyl-cellulose)

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Adenoviral conjunctivitis 1. Check for preauricular LAP. 2. Do a flouroscein stain to check for corneal involvement 3. Only prescribe plain topical antibiotics and lubricating drops 4. Dont give steroids

From the picture it doesn't look like the cornea is involved but stain it and check anyways. If it is involved, then that is an indication to start steroids. Since the patient is already on soft steroids (which don't seem to be working going by the appearance of the eye), I don't think there's anything wrong with starting stronger steroids and tapering. Of course the textbooks advise us otherwise, but this is my experience.

Sir how many days will it take to be completely normal again?
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BE acute viral conjunctivitis . This will take about 3 weeks to resolve. After 2 weeks there will be significant improvement. I am never satisfied with fml or loteprednol & don't use it anymore. Without strong steroids inflammation & redness & edema will not Decrease. They must be prescribed, of course in combination with at least 2 different antibiotics.Nsaids should also be prescribed for 10 days.

It might be bilateral viral conjunctivitis. Management: Tab Aceclo-plus bd 5 days Tab acyclovir 800 Mg's 5 times a days 7 days E/ o acyclovir 5 times topically in both conjunctival sac 10 days E/ d nepafenac 3 times a day 7 days E/ d CMC 4 times a day 10 days Exclude keratitis by fluorescein staining. Put on dark goggles to prevent photophobia.

Aciclovir does not help in viral conjunctivitis.On the contrary epithelial infiltrates may persist longer if they are prescribed. Nepafenac e/drops will not be helpful at all.
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Bilateral viral conjunctivitis , lid oedema, severe chemosis. Look for corneal involvement under slit lamp after flourescein staining. Cold compress its. Renicol/ocupol eye drops 2 hourly. Soft steroids floromethanol drops tid if no fl stain. Oral antiinflamatory tab tid. Should be ok in a week time even if no treatment.

@Dr. Harjeet Singh why steroid drops?
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1.Along with plain antibiotcs prescribe LYSER-D tablet -BD 2.Avoid steroids..

Case of bilateral adenoviral conjunctivitis One eye is affected more than the other usally. Look for pseudo membranes and sub epithelial infiltrates . If they are present evert the lids and peel of the membranes from upper and lower papers conjunctiva.start steroids topically qid and intense lubrication cold compression.depending on response taper the steroids or can change to low dose steroids once the severity of symptoms and signs comes down.continue lubricants for long time.

Presence of chemosis may sometimes follow topical antibiotic;it is almost impossible to predict which antibiotic will not produce allergy.Steroid or antivirals should not be used .I suggest that you change the brand of antibiotic, antiallergic drugs for 2 or 3 days.

ALERGIC DERMOPHEROCONJUCTIVITIS MAY BEVDUE TO TOPICEYE DROPS STOP ALL EYE MEDICATIONS FLOMETOLONE EYE DROPS NON STERIODAL ANTI INFLAMMATORY EYE DROPS OCULAR DECONGANT WITHBANTI HISTAMINIC EYE DROPS ARTIFICUAL TEARS SYSTEMIC ANTIBYISTAMINES

Definitely adenoviral conjunctivitis tobical antibiotics and lubricating eyedrops but the most important check for pseudomembranes and remove them if present continuous follow up antil day 21 ((((( noooo steroids )))))))

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