Should We Prescribe Vigamox Eye Drops for Pink Eye?

May 6, 2009

I see many patients who are referred to me by pediatricians and ER docs, and it seems they all are taking some fourth generation fluoroquinolone like Vigamox eye drops for bacterial conjunctivitis (or pink eye). What’s up with that? Is it just plain laziness to prescribe the same thing over and over? Or is it the result of drug rep pressure? I reserve these superdrugs to contact lens wearers. Otherwise, my patients with conjunctivitis get sulfa or gentamicin or some other cheap, old medicine. I wish doctors would take a moment before reflexively prescribing Vigamox and other very powerful drugs for what is a benign, self-limited disease.




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150 Responses to “Should We Prescribe Vigamox Eye Drops for Pink Eye?”

  1. Vinita on April 17th, 2012 1:58 pm

    my 3 month old son has been prescribed vigamox…there was lot of sticky discharge coming out if the eye….now eye is fine bur still doc says to put the drops.for 3 more months for first 15 days…somehow i feel its a strong drug..should that be given to a four month old child?

  2. Maureen on April 19th, 2012 7:26 am

    My 16 month old had what appeared to be a stye on his eyelid beneath the eyelash on Sunday. By Monday morning his eyelid was swollen. My husband took him to the pediatrician and was prescribed vigamox. When I got home around 2:30 the swelling seem to have decrease; however, after using the drop, the eyelid got red and swollen. Took him back to the pediatrician the next morning, as the eye was swollen shut by the time he woke up. However, upon getting to the doctor’s office, the swelling had reduced a bit. It’s 4 days later and his eye is still swollen. The medication doesn’t seem to be helping. His eyelid is red and swollen and the swelling no longer decrease once he’s awake and active. Could he be allergic to this medication? The one thing I had noticed earlier is that his eyelid seem to get red and swollen after administering the drop. Your thoughts please.


  3. ari on April 19th, 2012 10:15 am

    3 more months for 15 days? im not sure what that means.
    conjunctivitis typically should be treated no more than 7-10 days.

  4. ari on April 19th, 2012 10:16 am

    to shreya-
    sounds like you have a viral ilness. if you don’t wear contact lenses, and if no better in a week, see doctor

  5. Dr. Ari Weitzner on April 19th, 2012 10:20 am

    to maureen:
    a stye that does not resolve may be a chalazion, which requires hot compresses and antibiotic/steroid ointment. i advise going to the ophthalmologist. allergy to vigamox is pretty rare.

  6. kaushal saraiya on April 21st, 2012 1:08 am

    Hi Dr, dt : 21-04-2012

    Kaushal (India -Gujarat-Anand)

    My daughter had red eye on 2 nd march & 3 rd march both eye was red ( age – 5 months) , eye specialist first give us ( Gatilox – eye drop) its give us good result but after 4 to 5 days , 1 eye had swelling and so much red then eye specialist give us Nebracin Eye Ointment but after 2 to 3 days 1 eye was so much red then Eye specialist give us Vigamox , on 16th March she was good but , my wife , my father ,my Mother & self have red eye , and so much swelling and from 15 th we have lots of trouble, we were 3 times went to eye specialist thy give us” Gatifloxacin plus ketorolac ophthalmic solutation ” and “carboxymethylcellulose sodium lubricant eye drops” but on morning we all have so much swelling and eyes are so much red, tell me sir ,which disease we all have ? We have Epidemic Keratoconjunctivitis (EKC) ?

    Please give us your comment or Advise good medicine.


    Kaushal Saraiya

  7. ari on April 27th, 2012 3:19 pm

    sounds like viral conjunctivitis, like ekc. there’s nothing to do except wait for it to clear. consider a mild topical steroid drop.

  8. JeffO on May 9th, 2012 8:54 am

    My 4 yo daughter had a viral infection (moderate cold) that led to pink eye. It was immediately treated with Vigamox and within 24 hours had a severe allergic reaction causing swelling in both eyes, hypersensitivity to light and extreme restlessness. Although slowly improving after 24 hours without vigamox…Should we treat the reaction? Or just give it time? Thanks.

  9. Dr. Ari Weitzner on May 9th, 2012 9:16 am

    sounds viral, and i would leave it alone as long as it’s slowly improving.

  10. KT on May 25th, 2012 3:42 pm

    Dear Dr. Weitzner-

    My eyes have been a mess for a month now. Thought it was just pollen, so I’ve been waiting for all the crust and blurred vision to go away when spring passed. In the meantime, I developed what looks like a small stye as well. Over the past few days, the discharge has increased to a thick day-glo yellow/green — let’s call it chartreuse. Sometimes my vision gets very blurred from all the goo — I would probably fail a driving vision test today. Quit wearing eye makeup and started natural drops a couple days ago, but broke down this morning and went to the doc box. She prescribed Vigamox, which is what led me here. I have an autoimmune condition, and take Plaquenil, which may have a mild affect on the immune system. Nobody in my house has pink eye, and I’m otherwise free from viral symptoms. Guess I’m just looking for someone to back up the decision to use an antibiotic, and the the top gun RX at that. It’s really hard to get it in my eye, too, because the skin around my eyes is tight from my autoimmune condition, and I can’t pull it away much to make a pouch like the instructions suggest. My first attempt rolled right down my cheek, and the second drop moistened my eye just a bit. Any suggestions on that? THANK YOU!!!

  11. Dr. Ari Weitzner on May 25th, 2012 5:25 pm

    vigamox is big guns, but once you start it, you should continue. antibiotic makes sense if the discharge is gooey and yellow.
    lie on your back, close your eyes and squeezethe bottle onto the corner of your eyes- when you open your eys, the medicine will fall in. ta-da! it’s wasteful, but it works

  12. KT on May 27th, 2012 4:11 pm

    Thanks. You provide a great service to the interwebs! PS I’m already feeling better. I can see again, and my son doesn’t think I have zombie eyes anymore 🙂

  13. Ingrid on May 30th, 2012 10:09 pm

    M son was prescribed Vigamox for a very mild pink eye. He is 3 1/2 and this is the first time he’s ever had this problem. On the third dose, he got a hive-like reaction all over his body about 5 minutes after I gave him the drops. Again this has never happened for him (hives and rash all over). I could not get him to the doctor’s until tomorrow. Seeing that he has almost no pink left in his eyes, do I stop the drops tonight? I am a little upset after reading your post that the doctor even started him on this when he had very little pink to begin with. I wish I had read your post earlier. Thanks for your time and input!

  14. Nicole Dowd on June 8th, 2012 3:44 pm

    I started Moxeza on Sunday and finished my 5 days yesterday. My eye is still red, itchy, burning and watery. I am allergic to Sulfa, is Sulfa in Moxeza? I am a contact lense wearer but I haven’t worn them since Saturday!

  15. Dr. Ari Weitzner on June 9th, 2012 11:53 pm

    no sulfa in it. go back to ophthalmologist and have it re-examined- some contact lens related bugs are hard to kill with regular antibiotics

  16. Andrea on June 22nd, 2012 8:34 pm

    I have a question. About a month or so ago, I had an acute case of conjunctivities in my left eye. I was sitting on the couch when my eye suddenly started stinging and then white stuff came out and wouldn’t stop. I went to the eye doctor who said it was most likely viral but because of the inflammation of the eyelid he prescribed a steroid antibiotic drop. A few days later my right eye became infected which confirmed, to the doctor, that it was viral. It took about two weeks to clear completely. A few weeks later, I started waking up with red eyes and ocassionally at night there was a little white discharge in the right eye. Then one morning I woke up with white stuff coming out of my eye again. The eye was red and it appeared to clear up but I went to the doctor and he said this time it was bacterial and prescribed Vigamox (3 drops a day). The following night, my left eye started to water profusely for about an hour in the middle of the night too. It seems to have cleared except I still wake up with red eyes and some crusty stuff (very little). The right eye is still a bit scratchy slightly. The doctor also said to put a warm washcloth on the eye twice a week because he saw minor lid swelling.

    Basically I seem to have some reoccurring issues here. How do I stop this! I’ve washed everything I own, cleaned the house completely including electronics and bedding. I’ve stopped touching my eyes completely, using tissues only when necessary. I’ve thrown out all makeup and am using no makeup on or around the eyes. This is very frustrating. Is this still viral after almost two months? It’s very frustrating! Thanks.

  17. Dr. Ari Weitzner on June 24th, 2012 10:06 am

    sometimes viral conj can persist for weeks or months, but its certainly uncommon. i would rule out chlymadia and treat you with doxycycline for 2 weeks, as well as your sexual partner- this is a very common cause of chronic conjunctivitis in young people. i dont know your age.

  18. Andrea on June 24th, 2012 8:35 pm

    Thanks, doc. Chlamydia not likely. Happily married 6 years, been together 17. Not every realtionship is perfect but I have to say ours is pretty darn close. Best friends for 17 years is saying something! Recently had a full physical and nothing is wrong. Antibiotics might work, I suppose. I did take a Z pack ipback in April but sometimes those don’t work as well as other antibiotics. Funny thing is, I slept over someone else’s house last night, and woke up with no red eye even though I didn’t have my Vigamox with me and couldn’t take it all day. Starting to think it may be environmental.

  19. ari on June 24th, 2012 8:57 pm

    if you had no symptoms in another house, thats solid evidence its environmental. try to track down whats causing it.

  20. tosha on July 12th, 2012 8:18 am

    My 3yo son was diagnosed with pink eye (eyelid drooping, green discharge, eye is pink, pain when I touch his eye to clean it). The doctor prescribed Polymyxin, 1 drop, 3 times a day. After a day of treatment there’s still discharge but around his eye has become very swollen. Before he looked like a boxer a day or 2 after a fight & now he looks like the fight just ended! Could this be an allergic reaction?

    When my oldest had it 4 years ago the drops cleared it up in less than 24hrs but I can’t find out what he was given. I don’t think this was it.

  21. Dr. Ari Weitzner on July 12th, 2012 9:43 am

    it does sound like an allergy. consider switching to a difft antibiotic.

  22. tosha on July 12th, 2012 2:51 pm

    Thank you! I’ll make an appointment to take him in today.

  23. T Williams on July 12th, 2012 2:51 pm

    I recently slept in my contacts for a few hours. I woke up with a heavy feeling on my eyelids. Kinda like I want to involuntarily close my eyes. I am sensitive to light and my left eye is still red and running water. I have had a conoreal ulcer before.from infection while sick with a cold. When I blink I feel the irritation in my left eye.
    Is vigamox ok to use if I have it on hand? How long before I should statrt back using contacts? Also will pink eye relief help. I dont have insurance so my dr visiti would be 130 not counting my prescription.

  24. Dr. Ari Weitzner on July 12th, 2012 3:38 pm

    start the vigamox every hour and see ophthalmologists asap. dont even think of wearing your contacts.

  25. Fiona on July 17th, 2012 6:55 pm

    My daughter woke up with a crusty eye yesterday morning. I’ve been using Polymyxin B Sulfate and Trimethoprim Ophthalmic solution drops that had been prescribed for her for a previous eye infection. They expired in 2011 (I tried them in my own eye first just to make sure & no bad effects). There’s been no improvement yet after 1 1/2 days and I’m wondering if I should keep up the drops, or if they’ve lost their effectiveness. I have new “insurance” that makes prescriptions and appointments very expensive for me, so would like to avoid a trip to the doctor if at all possible. Any advice you have would be appreciated.

  26. ari on July 17th, 2012 8:00 pm

    expiration means little. give it a few more days.

  27. Fiona on July 17th, 2012 10:57 pm

    I will, thank you.

  28. JD Bliss on September 5th, 2012 7:03 pm

    My 16-month old daughter was diagnosed today with bacterial conjunctivitis. The pediatrician prescribed Polytrim.

    Having read the comments on this blog before, I asked the pediatrician how he knew it was bacterial rather than viral (in which case, I understood best treatment is to allow it to run its course without antibiotics).

    He said that the volume of green guck coming from her eye indicated a bacterial infection. So we went out and filled the Polytrim prescription.

    Any other parents out there who used Polytrim before?

  29. Casey on October 17th, 2012 6:43 pm

    Hi- I woke up this morning with a very red burning eye that is very sensitive to light exposure and feels sore to touch. I went to the care now and was perscribed vigamox after she briefly (for about 2 seconds) looked at my eye. I have had pink eye in the past but never the extreme light sensitivity and eye ball pain. Could it be something else? Should I continue with the vigamox?

  30. ari on October 22nd, 2012 9:28 am

    doesnt sound like pink eye. go to an ophthalmologist- sounds more like iritis. if you wear contacts, i suspect a corneal ulcer

  31. Charles on November 30th, 2012 12:00 pm

    Seems styes are over treated with wrong medications as well. I see a lot of folks put on gent drops for these lesions. Aren’t they mostly Staph and doesn’t gent have poor staph coverage? Can we just use topical heat and time? Or is gent drops ok?


  32. ari on December 6th, 2012 10:20 am

    actually, gent is perfectly good for eyelid staph- seems the eyelid staph is very sensitive. but i usually dont prescribe it- prefer bacitracin/erythro

  33. Jon on December 29th, 2012 5:36 am

    I have pink eye and was prescribed moxeza. I have been taking the drops for four days with very little difference in my symptoms. Is there an average time this virus lasts? Should I seek out stronger medication? Should I already be seeing improvement? Thank you.

  34. ari on December 31st, 2012 6:23 pm

    its viral- thats why the antibiotics dont help. it can last a week or two.

  35. NP Kiyara on January 11th, 2013 12:03 am

    My 18 Month old Daughter has been detected with Viral Conjunctiva on Monday. It grew Worse with Completely swollen Eyelids and shiny pinky surface skin.
    Wednesday she started bleeding from the Eye regularly. When she wakes up in the morning its all stuck and we clean it with room temperature water & Cotton.(boiled and then cooled water.)
    Today is friday and she had not slept the whole night. (waking up every 30min)
    She has very little visiblilty.
    Had been to child specialist and suggest to wait till saturday if it does not subside show he ophthalmologist.

    We are very scared.. .

    Medications given so far
    Monday – we started with Oflox.
    Tuesday – Continued Oflox.
    Wednesday – Thursday – used nothing…
    please assist

  36. ari on January 16th, 2013 4:45 pm

    sorry i didnt see this til now. a child with significant swelling of the lids need to be assessed for possible pre-septal cellulitis. you should see an ophthalmologist asap.

  37. AmyW on January 16th, 2013 10:40 pm

    my husband and I have had a sinus cold for a few days- my 16 month old likely had it first but his 3 yr old brother seems to not have gotten it. The baby had mild conjunctivitis with a little greenish goo appearing in the eye along with a couple days of voluminous snot but was fine with no treatment other than tylenol for mild fever. Both kids are in daycare, both my husband and I work outside the home. Yesterday I went to the optometrist, had my eye exam, tried on frames for my new prescription, Then the next day (today) in the middle of the day I wiped my eye and to my surprise there was a mass of green-yellow mucus. Mucus has been omniprsent ever since. I’ve not experienced this before. I don’t want to pass it to my kids or coworkers or take antibiotics unnecessarily. What are the chances I contracted bacterial conj. from my optometrist visit? How long is it from time of exposure to bacterial conj. to manifestation of symptoms? Should I really stay home from work? I also have a dentist appointment tomorrow – I couldn’t pass it on to anyone there could I?

  38. ari on January 17th, 2013 9:16 am

    it takes more than a day to get symptoms–usually 2-3 days, so i dont think you got it from the optom. sounds more like you got the virus from the kids. damn kids!
    dont touch anyone, and you wont spread it.

  39. Jeanie on January 21st, 2013 2:03 pm

    Woke up with my eye red which got progressively worse into the evening. Very light sensitive, in fact when I had the unaffected eye open the affected eye got extremely painful. Went to Urgent Care & the doctor said I have viral conjunctivitis. I’ve had pinkeye before but never as painful, red or light sensitive. I was prescribed Gentamicin and have been using it for 3 days every 4 hours. My concern is that my eye is still red and my vision is blurry in affected eye. Sometimes I get pain in the eye that lasts only a few seconds then goes away. Also my year duct feels weird. Doesn’t hurt but a bit itchy. Should I wait another 2 days before calling my regular doctor if symptoms go away? Is this normal?

  40. ari on January 23rd, 2013 10:44 pm

    doesnt sound like pinkeye. the light sensitivity is not typical- more typical with iritis. see ophthalmologist asap

  41. EBlue on March 1st, 2013 11:22 am

    Hi Dr. Weitzner,

    I appreciate your availability to answer so many questions from concerned parents. I wanted to clarify. I read almost every question and response on here. So I gather that if the patient has viral conjunctivitis (pink eye caused by a virus) then no antibiotic is necessary. One should let it run its course, but take measure to not spread because it is contagious. Then if it is bacterial conjunctivitis (pink eye caused by bacteria), one should absolutely see a physician to obtain antibiotic eye drops. The difference between the two would be viral pink eye would look slightly pink with some irritation and maybe some crusty eyelashes and then for bacterial pink eye would look like pink to red eyes with yellow, green discharge and more extreme crusting over eyes. This one is still contagious, but not as much as the viral pink eye.
    Sometimes its so difficult as a parent when so many doctors have different opinions. My family is so important to me and I do not want to have any of us to go through any unnecessary treatment. All medications have side effects.
    Thank you in advance for clarifying!

  42. ari on March 3rd, 2013 6:54 pm

    good summary!
    also–even bacterial conj will go away without treatment. its a self-limited disease. rarely, in kids, the infection will spread to the deep lids and even deeper and cause a cellulitis. so if it looks like its getting worse in kids, and the lids are getting progressively red and swollen, take to the doctor.

  43. KT on March 11th, 2013 12:18 pm

    My 5 year old daughter had pink eye. She would wake up in the morning with a crusty yellow eye and I would have to give her a bath to get it off her eye. This went on for a few days. I waited to see if it would go away by itself. Then I took her to the doctor and she was prescribed Vigamox. She took it twice a day for 7 days (it was supposed to be 3x a day but hard to give eye drops – she hates them.)

    A couple of days later I got pink eye. I tried to leave it but finally went to the doctors and they gave me Vigamox (3x a day) – the doctor said I could take it for 5 days or even just 3 days (which I never heard of. My daughter had it prescribed for 7 days). Today is day 5 and I took it this morning. When I take it my eyes burn in the front corners. I think this is because when I put the drops in my eyes I gently press in the corner so they don’t go down my sinuses.

    Is 5 days enough (or actually 4 days of taking it 3x per day and 1 day of taking it once). I am scared if I take more it will burn or hurt my eyes.

    I feel like the infection is gone. My left eye feels normal when I wake up but when i add the drops it kinda itches/irritates it. My right eye when I wake up has a slightly irritated feel. Very minor but when i add the drops it irritates it more.

    Are Vigamox drops dangerous at all – is there anything I need to watch out for? My eyes look fine but the inner corners look a little red (not the eyeball part but the pink pearly part in the eye).

  44. KT on March 11th, 2013 5:30 pm

    I just took another dose. So my question is – is 5 days enough on Vigamox? The drops are starting to make my eyes irritated and I took them 5 days (today is my last day on them but I only took two doses instead of three). Would this be enough to kill the bacteria?

    The Doctor said take for 5 days (he also said 3 on the drops would also be ok) – when I spoke to the pharmacist she said the doctor did not indicate on the prescription how many days and she said 5 days is usually enough. I took them for 5 even though the pamphlet says 7.

    I would like to stop taking the antiobiotics but am confused about how many days and also scared that if I don’t take the right amount that the bacteria will come back and I will have to start all over again.

  45. ari on March 11th, 2013 6:36 pm

    most antibiotics should be taken 7 days. vigamox cant possibly hurt your eyes. the shorter the course of antibiotics, the higher the risk of causing resistant bacteria to flourish.

  46. Misty on June 13th, 2013 6:17 pm

    I have appreciated reading all the info here. I am having my own rather bizarre story with conjuctivitis. I have 3 children ages 6,4,and 15 mo. The two older awoke with pinkeye in the right eye on morning 1. I treated with breastmilk (2 drops per eye every two hours) but as the condition only seemed to worsen on day 5 I took them to the clinic and got a perscription of polymxin B sulfate and Trimethoprin. The condition improved in 36 hours and I gave it fro the prescribed 7 days. On day 7 (4 days of meds) the baby awoke with pink eye. I started him on the drops. By the time he was on day 4 of the drops my 6 year old (now prescription free for 3 days) contracted pink eye again. I simply put him back on the antibiotic. Then I contracted pink eye. So we were all on antibiotic at the same time for a few days. I cleaned EVERYTHING or so it seems. I had 2 days left of antibiotic for me to have 7 days. This morning baby awoke with pink eye again.

    And so now I think I need to return to the doctor (or clinic as we are between doctors having moved). But I’m not even sure who all to take in at this point. We’ve also apparently given it to our little neighbor girl (just today she has red eyes too) although we stayed away from them until we were all clear and on antibiotic 48 hours.

    Thoughts? Suggestions? What should I expect?

    Thank you so much. I’ve not heard of such a stubborn experience.

  47. ari on June 14th, 2013 9:01 am

    sounds like typical contagious viral conjunctivitis. it will go away by itself, regardless of drops.

  48. Pris on July 27th, 2013 1:42 am

    My 6 year old was prescribed with Vigamox for 7 days 3 times a day for pink eye. After a week, it returned and his pediatrician said to take it for 7 more days. On the fifth day of the second week he took it, we had been at the beach and when I put the drop it, it burned his eye, so I didn’t give it to him anymore. The pediatrician saw his eye and said he had a small corneal abrasion and referred him to an eye doctor, but he didn’t see anything in his eye and prescribed Genteal drops four times a day. My concern is that now, he’s always blinking and sometimes feels something in his eye. Could damage have been done because of taking the Vigamox for so long?
    Thank you.

  49. ari on August 5th, 2013 11:52 pm

    no- vigamox cant hurt the eye. you can chill! if he’s still blinking after a week or so, go to the ophthalmologist

  50. Shannon Macomber on February 9th, 2014 11:57 am

    I took my 7 yr old son to the emergency room late last night. He was diagnosed with Conjunctivitis. They gave me a prescription for Trimethoprim-polymyxin b (polytrim). I am currently unemployed and do not have the money for the prescription. However, I do have a bottle of polytrim in my medicine cabinet that has an expiration date of 09/13. Are they still effective?

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