Context

Acute infective conjunctivitis is the commonest ocular problem encountered in general practice. Traditionally most patients were prescribed topical antibiotics, essentially to cover for bacterial causes. Despite some evidence of improved clinical and microbiological remission rates with antibiotic use in bacterial conjunctivitis, most patients with acute infective conjunctivitis will get better without antibiotics.1 ,2 Viral infections are more common than bacterial, especially in adults, and are usually self-limiting.1,–,3 With this knowledge, prescribing guidance has changed in the last decade and suggests delayed or deferred use of topical antibiotics.2 ,4 ‘Over-the-counter’ chloramphenicol risks unnecessary treatment and delayed diagnosis of alternative conditions.