Minor ailments

Conjunctivitis (bacterial, allergic, or viral)

Clinical basis & sources

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Allowable drugs under Schedule 4 (17)

Drugs an Ontario pharmacist may prescribe for Conjunctivitis (bacterial, allergic, or viral) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.

  • Antazoline
  • Bepotastine
  • Cromolyn sodium
  • Erythromycin
  • Fusidic acid
  • Gramicidin
  • Ketotifen
  • Lodoxamide
  • Naphazoline
  • Olopatadine
  • Oxymetazoline
  • Pheniramine
  • Phenylephrine
  • Polymyxin B
  • Tetrahydrozoline
  • Tobramycin
  • Trimethoprim

Symptoms this assessment screens

  • Red or irritated eye(s)
  • Itching (prominent)
  • Watery discharge / tearing
  • Thick or purulent discharge; lashes matted shut on waking
  • Gritty or foreign-body sensation
  • Recent cold / upper respiratory infection or contact with pink eye
  • Both eyes affected
  • Seasonal or known allergen trigger

Red flags — any positive means refer

  • Eye pain beyond mild irritation
  • Reduced or blurred vision
  • Photophobia (light sensitivity)
  • Contact-lens wearer with a red eye
  • Trauma, chemical exposure, or foreign-body concern
  • Severe unilateral redness with headache, nausea, or halos
  • Suspected herpes (eyelid vesicles, dendritic ulcer, prior herpes simplex virus keratitis)
  • Marked eyelid swelling, fever, or periorbital cellulitis concern
  • Immunocompromised patient with concerning symptoms
  • Newborn, infant, or very young child
  • Recurrent, persistent (> 2 weeks), or not improving

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