American Academy of Ophthalmology

View all recommendations from this society

Released February 21, 2013

Don’t order antibiotics for adenoviral conjunctivitis (pink eye).

Adenoviral conjunctivitis and bacterial conjunctivitis are different forms of infection that can be diagnosed by the ophthalmologist by clinical signs and symptoms, and if needed, by cultures. Antibiotics are useful for patients with bacterial conjunctivitis, particularly those with moderate to severe bacterial conjunctivitis. However, they are not useful for adenoviral conjunctivitis, and the overuse of antibiotics can lead to the emergence of bacteria that don’t respond readily to available treatments. In cases of diagnostic uncertainty, patients may be followed closely to see if their condition resolves on its own, or if further treatment is required.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about items on this list or their individual situation should consult their ophthalmologist.

How The List Was Created

The American Academy of Ophthalmology’s Medical Director of Health Policy and Health Policy Committee led the Academy’s list development process. Members of the Health Policy Committee initially identified potential recommendations based on relevance, appropriateness and potential for improvement and efficiency. Through society notifications and newsletter notices, other ophthalmic organizations and subspecialty societies and members were invited to offer feedback and recommend ideas to be included in the final recommendations. Health Policy Committee members and the Medical Director of Health Policy reviewed the ideas and supporting evidence, and ranked them in order of potential impact. The top five recommendations were presented to the Academy’s Board of Trustees for approval.

The American Academy of Ophthalmology’s disclosure and conflict of interest policy can be found at


American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern® Guidelines. Conjunctivitis – Limited revision [Internet]. San Francisco, CA: American Academy of Ophthalmology; 2011 [cited 2012 Sep 28]. Available from:

Sheikh A, Hurwitz B. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev 2006 Issue 2. Art No: CD001211. DOI: 10.1002/14651858. CD001211.pub2.