Bacterial - Hyperacute

- Usually unilateral with a fulminant onset (< 24 hours)

- Copious purulent discharge, conjunctival hyperemia, redness, and irritation. Preauricular lymphadenopathy commonly seen.

- Corneal perforation can occur in up to 10% of cases. Refer to an ophthalmologist promptly.

- Obtain Gram stain and culture of conjunctival scrapings.

- Consider adjunctive topical antibiotic therapy (bacitracin-polymyxin or erythromycin).

Usual Pathogens

N. gonorrhoeae
N. meningitidis