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There are many causes of patients having red eye. Red eye is an ocular inflammation and according to Penn Medicine (n.d.), conjunctivitis is the common cause of red eye. Conjunctivitis is the most common eye infection seen in primary care which could be infectious or non-infectious and commonly due to viral or bacterial conjunctivitis. Although bacterial conjunctivitis are more common in children, “80% of acute cases of conjunctivitis are viral caused by adenovirus” (Hashmi et al, 2022). Therefore, assessment and physical examination are key in the diagnosis, determining the cause and treatment of conjunctivitis.
During the diagnosis process, NP should assess the history of symptoms, onset and aggravating or contributing factors. According to the American Family Physician (2010), viral conjunctivitis is often associated with an upper respiratory infection, whereas bacterial conjunctivitis, is highly contagious and can have copious, purulent discharge, pain and vision loss. Although the patient denies any visual disturbances, a comprehensive eye examination is necessary to ensure vison has not been affected. According to the American Optometric Association, these eye examination will include evaluation of the conjunctiva, external eye tissue and the inner structures of the eye that may warrant referral to ophthalmologist or optometrist for further evaluation (n.d.). Test such as cultures and smears may also be done if the condition is suspected to be caused by bacteria or if condition is not responding to treatments.
Based on the presenting symptoms in the case study, it is highly possible that the diagnosis is viral conjunctivitis. Therefore, the pharmacological based from the American Family Physician guidelines on viral conjunctivitis, the pharmacological approach will include;
Generic
Brand
Direction
Indication
Acetaminophen
Tylenol
For children 1-12 years old, Take 10-15mg/kg/dose every 6 hours. Do not exceed 5 doses in 24 hours. (Valland and Sanoski, 2021, pg. 100).
For adults, 650 mg by mouth every 6 hours as needed. Do not exceed 3 grams in 24 hours or 2 grams in 24 hours with hepatic or renal impairment (Valland and Sanoski, 2021, pg. 101).
Fever
Artificial Tears
Instill 1 -2 drops to affected eye 3-4 times a day.
Eye dryness
For non-pharmacologic approach; prevention of transmission will be highlighted. This will include teaching on strict frequent hand washing and eye hygiene. Washing frequently will reduce the spread to the other eye and to others. Change pillowcases every time until condition resolves. Instruct the parents to wash discharge from around the patients eyes several times a day. Try to limit touching eyes. Avoid sharing of washcloths and use separate washcloth on the affected eye.
The management and treatment of conjunctivitis on children versus adult and geriatrics are similar. However, a difference may include in the dosing of the recommended medications and other non-pharmacological treatment such as; if contact lens are use, avoiding wearing them until the inflammation resolves and discard or disinfect contact lenses before use; discard eye makeup and avoid sharing, A follow up visit is recommended after 7 to 10 days to evaluate effectiveness of treatment.
References
American Family Physician. (2010). Diagnosis and management of red eye in primary care.
https://www.aafp.org/pubs/afp/issues/2010/0115/p13…
American Optometric Association. (n.d.). Conjunctivitis. https://www.aoa.org/healthy-
eyes/eye-and-vision-conditions/conjunctivitis?sso=y
Hashmi, M., Gurnani, B. and Benson, S. (2022, December 6). Conjunctivitis.
https://www.ncbi.nlm.nih.gov/books/NBK541034/
Penn Medicine. (n.d.). Conjuntivitis (pink eye). https://www.pennmedicine.org/for-patients-
and-visitors/patient-information/conditions-treated-a-to-z/conjunctivitis-pink-eye
Valland, A, and Sanoski, C. (2021). Acetaminophen. Davis’s drug guide for nurses (17th ed.). A.
Davis Compa
