Distinguishing types of acute conjunctivitis

	Bacterial	Viral	Allergic
Systemic symptoms.	Usually none.	May be part of a viral prodrome followed by adenopathy, fever, pharyngitis, and upper respiratory tract infection. There may be an enlarged and tender preauricular node.	Nasal congestion, sneezing, wheezing.
Itching.	Limited to none.	Limited to none. Primary complaint is grittiness, burning or irritation.	Primary complaint. May also report grittiness, burning, or irritation.
Ocular discharge.	Purulent, may be yellow, white, or green. Recurs at lid margins and corners of the eye within minutes of wiping lids.	Watery with strands of mucus.	Watery.
Conjunctival appearance.	Pink or red.	Pink or red. Very rarely hemorrhagic. Tarsal conjunctiva may have a follicular or "bumpy" appearance.	Pink. Bulbar conjunctiva may be chemotic (puffy). Tarsal conjunctiva may have a follicular or "bumpy" appearance.

Graphic 128098 Version 2.0