Q&A

Conjunctivitis: Diagnostic usefulness of signs and symptoms unknown

J Fam Pract. 2004 February;53(2):93-105
By
Eric M. Rotert, MD
Beth Potter, MD
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  • BACKGROUND: Primary care providers often prescribe antibiotics based on physical findings of papillary conjunctivitis, mucopurulent discharge, and rapid spread between eyes. However, though often recommended in ophthalmologic texts, the evidence supporting these criteria is unknown.
  • STUDY DESIGN AND VALIDITY: The researchers searched 4 databases (PubMed, Embase, CINAHL, and Cochrane Controlled Trials Register) and manually searched bibliographies from relevant articles, guidelines, and textbooks to find 2903 articles regarding diagnostic accuracy. They included studies comparing signs, symptoms, or both with bacterial culture.
  • RESULTS: This systematic review did not find any evidence to support or refute the clinical criteria physicians commonly use to distinguish bacterial from viral conjunctivitis.
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PRACTICE RECOMMENDATIONS

Despite recommendations in ophthalmologic texts for differentiating bacterial from viral conjunctivitis, no research supports the usefulness of any signs or symptoms to make this distinction. This raises validity questions about treatment studies based on clinically diagnosed bacterial conjunctivitis.

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