By: Naomi Zilkha, MD (Telemedicine, Allied Physicians Group)
Hi Allied! It’s #TelemedicineTuesday
I can summarize this week in after-hours Telemedicine in 2 words: Pink Eye.
So, there are 3 main types of pink eye (aka conjunctivitis) that I see in telemedicine:
1) allergic conjunctivitis
2) viral conjunctivitis
3) bacterial conjunctivitis
How do I tell the difference?
1) Allergic conjunctivitis usually happens when patients are outside, or if there are many windows open inside. The worst time of year for allergic conjunctivitis is early spring when tree pollen is in full force (which is over now). Normally, it also comes with a runny nose, and both eyes itching terribly, and they might even be burning and swollen.
2) Viral conjunctivitis is commonly seen this time of year. One of the main viruses that cause it is the adenovirus, which usually doesn’t just have pink eye as a symptom. Often it comes with a sore throat and more cold symptoms like runny nose and cough. Usually, both eyes are affected.
3) Bacterial conjunctivitis is actually what I saw the most of this week. Often there’s a history of a family member, friend, or classmate(s) with pink eye because this type of pink eye is super-contagious. This week, all my patients with pink eye had pretty straight forward bacterial conjunctivitis; with only one eye affected, and lots of pus coming out of that eye, history of someone close to them having pink eye very recently, and no other symptoms at all.
How can I treat them in after-hours Telemedicine?
1) Allergic conjunctivitis: I normally go over the patient’s allergy history, see what meds they are taken/have taken in the past. I often recommend over the counter eye drops like Zafitor, and often add a non-sedating antihistamine like Claritin, Zyrtec or Allegra to help them be more comfortable for the night
2) Viral conjunctivitis: I usually go over symptomatic care to make the patient feel better for the evening, and I often recommend being seen the next morning to confirm that there’s no ear infection (ear infections and pink eye like to come together) and that it really seems to be viral. Treating viral conjunctivitis with antibacterial drops won’t help. If the eyes are really irritated, I recommend preservative-free over the counter eye lubricating drops (which are like adding extra tears)
3) Bacterial conjunctivitis: this is what I saw this week, and is the easiest to treat; I treat with a prescription eye drop. Even if it’s just one eye, I always recommend treating both eyes since it’s so super-contagious from one eye to the other and from one person to the other. I also recommend trying to have the patient not rub the eyes, and for towels not to be shared by family members
Remember, for after-hours urgent care, #ThinkAlliedTeledicine first!