Conjunctivitis – Infective

Eye affected (right, left, both)


Eye discharge color (clear, yellow, green)


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Reports Presence of redness in the white of the eye Itching Irritation Swelling of eyelid Sensation of a foreign body in the eye Photophobia Watery eyes

Reports No presence of redness in the white of the eye No itching No irritation No swelling of eyelid No sensation of a foreign body in the eye No photophobia No watery eyes

Report negative symptoms?

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Red Flag Symptoms

Reports Blurred vision Photophobia Severe eye pain Severe headache Fever Symptoms not improving with treatment Loss of vision Reduced vision Halos around lights History of recent injury to the eye

Reports No blurred vision No photophobia No severe eye pain No severe headache No fever Symptoms improving with treatment No loss of vision No reduced vision No halos around lights No history of recent injury to the eye

Report negative symptoms?

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Has a history of Recent upper respiratory tract infection Recent viral illness Exposure to someone with conjunctivitis Exposure to someone with a respiratory tract infection Contact with allergens Contact with irritants Use of topical medications

Reports No recent upper respiratory tract infection No recent viral illness No exposure to someone with conjunctivitis No exposure to someone with a respiratory tract infection No contact with allergens No contact with irritants No use of topical medications

Report negative symptoms?

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Details of any topical treatments used (antibiotic eye drops, antiviral eye drops, corticosteroid eye drops)


Details of any systemic treatments used (oral antibiotics, oral antiviral medications, oral antihistamines)


Compliance with prescribed treatments


Response to treatment (improvement, no change, worsening of symptoms)


Use of symptomatic relief measures (cool compresses, artificial tears)


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Any other relevant details



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