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. R Kautz on May 6th, 2009 2:40 pm

    Are you serious? sulfa? Weren’t sulfas invented during the civil war (REALLY)?
    I like to think patients come to me for the most current treatments, not one that will cause an allergic reaction.

  2. Dr. Weitzner on May 6th, 2009 2:58 pm

    if you notice, your comment doesn’t refute anything i wrote, which i find frustrating. i have been using sulfacetamide solution (bleph-10 is the brand) for eye infections for 15 years, and have never seen a reaction ( i like to ask patients if they have a sulfa allergy- comes in handy!). it’s very easy to treat everything with superdrugs. the skill as a clinician comes knowing when not to use them. i am happy to give my patients superdrugs when and if they really need them. explain to me why bacterial conjunctivitis, a benign, self-limited disease (that goes away even if you don’t treat it), needs a $120 bottle of superdrug vs. a $10 drug that is just as good? by the way, penicillin is about 60 years old, but is still often used in many infections ( i think it’s still drug of choice in some meningitides), since it works. that should be the measure of its worth, not its age. give this matter some serious thought, and let me know what you think.

  3. Sarah Desmond, CPNP on September 13th, 2009 5:55 am

    I Agree with Dr. Weitzner – why ARE so many people using the new drugs so much? I still use gentamycin, sulfacetamide, erythromycin for bacterial conjunctivitis. If they fail that, then I’ll culture and try something else. I have the same problem with prescribing Azithromycin for bronchitis in kids. Granted, I teach pharmacology, so I like to practice what I preach, but aren’t we just asking for drug resistance? Not to mention the cost………..

  4. Amber on March 12th, 2010 10:04 am

    Dr. Weitzner,
    I appreciate your comment and agree completely with your outlook. I did not know I had other options when my little girl was treated with Vigamox for bacterial conjunctivitis. She took two doses each day for five days, it went away (or so I thought). Then her little brother got the conjunctivitis, was treated with the same drug for five days, and it appeared to go away. However, now my husband has it and shortly thereafter, my two children got traces of it again, and they are all on this expensive medicine (yet again) for the next five days. We do not have insurance, and this tiny bottle of medicine is $95. If I had known I had other options, I would not have given anyone anything and would have just isolated my little girl, sterilized everything, and waited for it to pass. My question now is… if after a week of using vigamox, and it returns, do I have any other option but to continue buying this expensive drug or can I wait it out? I have spoken to our pediatrician and doctor and they say we have no option.

  5. Dr. Ari Weitzner on March 14th, 2010 3:17 am

    most conjunctivitis is viral and is NOT treated AT ALL, like when you catch a cold. the fact that it was so contagious in your family makes me 99% certain it was viral- bacterial not nearly as contagious. therefore, the vigamox, or any drop you took, was worthless- the course would have been the same.

    here’s what i say to my patients with conjunctivits: “i am going to give you what i give my own children when they get pink eye– nothing. and just like it goes away in about a week with them on no treatment, so it will with you”. my patients find it reassuring that an ophthalmologist doesnt even treat his own kids.

    so, leave your family alone, and it will go away sooner or later- guaranteed!

  6. Ashley on March 23rd, 2010 9:26 pm

    As a healthcare provider with small children with conjunctivitis, I waited about 6 days, no treatment, and with no change when I got conjunctivits, (hoping it was viral).

    Then I got a Rx for Gentamicin (gentamicin has always worked in the past). I saw improvement the first three days, then both eyes flared up worse than ever before. I stopped taking anything for a few days and was gradually getting worse.

    Got Rx for Vigamox and am slowly seeing improvement. If I didn’t see improvement, I would have had bacteria cultured. Glad there are these drugs on the market, but I agree they shouldn’t be first line of defense.

  7. ari weitzner on March 24th, 2010 11:11 am

    i suspect that the gentamicin made the eyes feel better initially simply due to lubrication, and would have produced same results as artificial tears.

    viral conj can last up to 2 weeks or even more. as long as not getting worse, i would have waited another week.

    hard to explain why the gent made it worse if the gent agreed with you in the past (gent can irritate the eyes in many patients and makes the conj look worse).
    but agree if eyes getting worse after gent, no choice but to go to the big guns like vigamax. but if there wasn’t significant discharge going on, hard to believe we are dealing with a resistant bacterial organism.

    it bears repeating that even bacterial conj is a self-limited disease and will go away no matter what (except in cases of std’s). so, again, i would advise waiting at least 2 weeks as long as its not getting worse and see no signs of significant bacterial infection like heavy discharge etc.

    as i mentioned, i never treat my own children, to my wife’s chagrin (“you’re an eye doctor!! can’t you give them something?!” “shut up, honey dear!”)

  8. John V on June 4th, 2010 9:59 am

    My daughter (5yrs old) got mild pink eye with green discharge and crust on the eyelashes. We waited 2 days before going to the walk in clinic.

    We got the Vigamox and started the treatment. Her eye is better but she also has a cough and stuffy nose.

    Dr. Weitzner when you say:
    “i am going to give you what i give my own children when they get pink eye– nothing. and just like it goes away in about a week with them on no treatment, so it will with you”.

    My daughter is in school JK half days. How long should she stay home if we didn’t use the VIgamox?

  9. Dr. Ari Weitzner on June 4th, 2010 7:16 pm

    most conjunctivitis is contagious for about a week, so thats how long she should stay out of school. if the conjunctivitis is bacterial, and she did not use vigamox, i dont think it would make much of a difference re contagion, as most conjunctivitis gets better in about a week regardless of treatment. but if its a nasty case, and there is still green discharge after a week, then she is probably still contagious.

  10. Uche on June 17th, 2010 3:50 am

    I also thought that my daughter was prescribed moxifloxacin ophth. drop too soon in the course of her conjuctivitis. Her red eye appeared after swimming in a hotel pool. I first thought it was an allergy and tried visine for two days, to get the red eye (unilateral-Rt) out and stop the irritation. I began to notice that the red eye got worse and she complained of severe itchiness. I started noticing some discharge (slightly yellowish) and sticky eye. I also noticed that the Lt. eye was a bit pinkish. Now that she has used Vigamox three times a day for 2 days, the Rt. eye has gotten worse. It is swollen and more reddish than ever. She is now experincing watery eyes, and itchiness, along with “stye”. She is also having some stuffy nose. I have been applying warm water to her eyes as advised by her pediatrician. I plan to contact her pediatrician tomorrow to report these reactions. I will not be instilling further drops until I have a chance to consult with her pediatrician. I actually wondered the use of fluoroquinolone as the first line agent.

  11. Dr. Ari Weitzner on June 22nd, 2010 2:42 pm

    the pink eye just ran its course regardless of the vigamox. once started, however, once started, its a good idea to finish the course of antibiotics.

  12. Sharo on July 8th, 2010 1:26 pm

    Wow, as a patient with pink eye for the first time, this is all very confusing. After a day with a very red and itchy right eye, I called the doctors office. I was concerned about whether or not I should be going to work (i.e. around other people.)

    Based on my symptoms (no contacts, no yellow discharge) the doc said it was most likely viral, but I should use the anti-bacterial drops “just in case.” She said even if it’s viral “it can’t hurt.” I even pushed back a bit, saying I don’t like to take antibiotics if they are not necessary, and she told me not to worry, that they’re “just eye drops” and that she wasn’t putting me on antibiotics. She told me to stay home from work for 24 hours.

    I went and got the $75 (!!!) drops. Before using any drops, the right eye seemed to be improving (not as itchy) but I saw signs of redness and itchyness in the left eye, so I began the Vigamox regimine.

    The doctor said that she treats eye infections “conservatively” and even threw out there that untreated infections can cause blindness (scare tactic??) Basically, a better safe than sorry approach.

    I would have been willing to wait things out, but was/am still concerned about returning to work. I cannot afford to stay home for a week! Should I still be quarantined? Can I return, but just be careful about touching, hand-washing and sanitizing? I’m assuming since I’ve already paid for and started the Vigamox that I should continue.

  13. ari weitzner on July 13th, 2010 9:04 am

    sounds like typical viral conjunctivitis, but since you started the Vigamox drops, you ought to finish the course.
    if viral, and you work with kids, you ought to stay home for a week- very contagious. otherwise, if you dont touch anyone, wash your hands a lot and use a hand sanitizer and wipe off your work station, you can go back to work.

  14. amy turner on July 27th, 2010 5:37 pm

    I am allergic to sulfa, tobramycin, azasite, keratolac, gentamycin, and neomycin. I’ve just been prescribed vigamox and told it does not contain sulfa and shouldn’t be pose a problem given my allergies to other medications. Do you agree with that?
    Thank you very much

  15. ari weitzner on July 27th, 2010 8:46 pm

    i agree!

  16. Angelina Mattera on August 18th, 2010 6:31 pm

    I went to the doctor yesterday with what I think was a strep throat. He never really verified what it was, but did prescribe me Cephalexin. Today I woke up with pink eye and I was wondering if the two could be related? If so, would if the antibiotic he prescribed help with the pink eye as well?

    Thanks for your help in advance!

  17. Rache'l Clark on August 22nd, 2010 1:05 am

    I am 63 years old and have had conjunctivitis for over a month now–bacterial. I have used Polymixin B Sulfate, used it for a week and my eyes were marginally better. Four days later it was back. Went to my own doctor and he prescribed Gentamicin. Was on it for 5 days and my eyes got so bad with green matter and all the whites of BOTH eyes were filled with blood and the orbs and bone around them were terribly painful. It even hurt the eye muscles to blink my eyes. He then prescribed Vigamox as my last resort. It was $85 at Wal-Mart. (I have no insurance). Since it was so expensive, I used it for 11.5 days. And once again, my eyes were not cleared up. This all started July 13, 2010. Today is Aug. 21, 2010.
    I did a photo shoot today, in terribly hot weather, so the sweat was running down into my eyes, and tonight lots of green matter and terrible redness is back with me.
    So in my estimation, Vigamox does NOT clear conjunctivitis up!
    Is there ANYTHING that will help?????? Very Frustrated!

  18. Dr. Ari Weitzner on August 22nd, 2010 2:43 pm

    conjunctivitis is a self-limited disease. it always goes away, treated or not. which is why vigamox is just plain overkill. viral conj can last for weeks or even months sometimes, and is not treatable, but typically the discharge is whitish and scant.

    blepharitis can mimic conjunctivitis, and is very very common as we get older. the treatment for that is good lid hygiene, taking flaxseed/omega three supplements, and an antibiotic called azasite every night, sometimes indefinitely.

    btw, the cephalaxin will treat your pinkeye if its truly bacterial. if its viral (most sore throat is viral) it wont make a difference

  19. Kacy B on August 23rd, 2010 9:02 pm

    My 3 year old son has conjunctivitis. We started the Vigamox last Friday evening and since then the yellow-sticky discharge has cleared but there is much more inflammation and discomfort with increased blepharodema, photophobia and blepharospasm. Today he developed fever and also has symptoms of rhinitis and sore throat. His doc put him on systemic antibiotics so with the oral a/b is it still so important to administer the Vigamox for the full course.

  20. ari weitzner on August 26th, 2010 7:39 pm

    once started, always important to finish the full course.

  21. Uche on September 20th, 2010 11:56 am

    Dr. Ari Weitzner,
    I wrote on June 17, 2010. As it turns out, my daughter was diagnosed with Ocular Herpes simplex, affecting her cornea. She has been on long therapy with antiviral oral, as well as ophthalamic drop, and steroidal drops too.
    Why didn’t any doctor noticed that from when I complained her swollen eye? I actually forced the Urgent care doctor, after 2 visits within a week, to prescribe the antiviral and he finally did. I also requested of her pediatrician for a recommendation to an ophthamologist and he did. It’s September now and she’s been on antiviral oral, as well as ophthalamic drop, and steroidal drops too with close monitoring since there’s a corneal scar and ulceration (Herpetic Stroma Keratitis). I am a highly concerned mother. Any suggestions as to complete eradication of this horrible virus?

  22. ari on September 20th, 2010 12:09 pm

    i would prefer not to email you directly- it may imply a doctor-patient relationship.

    only if the exam were suspicious for herpes would even an ophthalmologist consider that diagnosis initially (vesicles/rash on the lids; a lot of pain). hard to blame an ophthalmologist for missing that initially. if things not getting better after a week or so, then the ophthalmologist should not miss it. if the patient were seen by a non-ophthalmologist, then the odds of picking up herpes would be almost nil. this is why most doctors hate treating the eye and refer immediately.

    the current regimen you describe is correct. hopefully, the scar tissue will be minimal and not affect the vision to any significant degree, which is usually the case. taking oral anti-virals indefinitely will probably reduce the risk of recurrence, but you have to discuss that with the ophthal. the virus cannot be eradicated- 95% of americans harbor the virus.

  23. PAtricia on November 11th, 2010 1:16 pm

    This is all so Interesting and informative, I have a question is vigamox safe for my 11 month old grand daughter ?? Thank you very much.

  24. Dr. Ari Weitzner on November 13th, 2010 8:29 pm

    very hard to answer this question. what is the disease? what did her ophthalmologist say?
    in general, most drops not tested in kids, but typically, we use it in kids regardless.

  25. Kathy on January 26th, 2011 3:16 am

    I was diagnosed with a corneal ulcer and put on vigamox. I told them I was allergic to Avelox, and I found out today that the two contain the same medicine. I have a low grade fever, some feelings of fullness in my head, especially around my ears and my affected eye has turned slightly yellow. My eye is getting much better, but now I feel just plain ill. Is this an allergic reaction or an unrelated virus? Thanks in advance.

  26. ari weitzner on January 26th, 2011 12:59 pm

    i suspect you have a virus. if the drop were the cause, i would expect to see quite a bit of redness, swelling and itching around the eye.

  27. JenL on February 19th, 2011 12:24 pm

    I’m so glad to see you on here! My son and daughter had strep, and then my son had pinkeye (or so I called it). His pedicatrician prescribed the superexpensive Vigamox, which did clear up his eye… or at least his eye did clear after four days or so. Then I got the same about the time his cleared, only my lids are more swollen. I immediately started taking the Vigamox, thinking 7 days worth would be available with half the bottle left. My eye is just starting to get better, and I’m on day four with no drops left. I do, however, have erythromycin ointment. Would it be harmful to switch midway or quit altogether? I know it’s best to finish, but it is the weekend and that would mean clinic care with no insurance… eek! :-) I’ve also used colloidal silver on a cotton ball to wipe the eyes. The bottle says not to put it in the eyes, but it certainly is tempting! Thank you so much for your time and consideration in answering!!!

  28. JenL on February 19th, 2011 12:26 pm

    I forgot to mention that I woke in the middle of the night, sat up, and liquid just poured out of my left eye. The same happened the next morning. It wasn’t as bad last night. There was less discharge. I’m guessing that could be of importance! Thank you again.

  29. Dr. Ari Weitzner on February 20th, 2011 6:33 pm

    sounds like this is viral conjunctivitis, and most likely no treatment is necessary. even though one should finish antibiotics once started, most likely it wont make a difference here, and odds are you will get better in a week or so. i assume you do not wear contact lenses- if so, all bets are off. I should that if you have any doubts, please consult with your eye doctor.

  30. JenL on February 22nd, 2011 9:28 am

    Thank you so much for your response!

  31. ChrisP on March 11th, 2011 12:09 pm

    Dear Dr. Weitzner,

    One week ago my 18-year-old daughter was diagnosed with an eye infection. She started Bleph 10 and cleared up instantly. Five days later my eye displayed similar symptoms so I started the same drops. Because my symptoms rapidly deteriorated (swelling and yellow-green discharged), I went in to my doctor in the afternoon.He recommended continuing with the Bleph 10 for two full days as it helped my daughter, but to switch to Moxeza after two days if no improvement. This morning (Friday, after one day of Bleph 10), my eye is nearly swollen shut and the other eye is infected. The significant complication here is I need to fly on Monday morning with my daughter for a scholarship audition. I am most concerned about travelling and not having relief with my symptoms. I also woke up with a sore throat this morning. I appreciate the distinction between viral and bacterial concerns. Is there a problem with switching earlier to the Moxeza? I need to travel on Monday!

  32. ari on March 12th, 2011 2:10 pm

    still probably viral, but i see no reason not to switch now. But please consult with your eye doctor for a full evaluation.

  33. samantha on March 20th, 2011 3:17 pm

    What about the use of colloidal silver for eye infections as a more natural remedy?

  34. ari on March 21st, 2011 1:14 pm

    no scientific proof behind colloidal silver. just like no scientific proof zinc or vitamin c can help a cold. sure, they are widely used, and one hears all kinds of stories about how they help- but no scientific proof. an d remember- most pink eyes go away in about 5 days, so when people take any of these remedies, and they get better, they think it’s the remedy, but the fact is they would get better anyway. thats how these stories get started. like antibiotics for ear infections- turns out, the vast majority get better without them, yet for decades, we assumed it was the antibiotics.

  35. Mariana on March 21st, 2011 2:50 pm

    Dear Dr. Weitzner,
    6 days ago my 2 year old son was prescribed Vigamox for pink eye.
    After a day his eyes got better but after 3 days he got hives on his body.
    The pediatrician and I decided to stop the Vigamox. The hives almost disappeared but his eyes got red, watery and with a yellow discharge again. The doctor prescribed Ofloxacin which has fluoroquinolone and it says that the side effects of
    it can be hives. It is almost the same antibiotic. The doctor says it should be OK but I am afraid he might get even a worse reaction. What do you think? Should I start the new drops, continue with Vigamox or just wait. Thank you very much.

  36. ari weitzner on March 21st, 2011 8:06 pm

    i dont understand how one can get an allergic reaction on the body from vigamox, while the eyes, which are getting the drug directly, is unaffected. just doesnt makes sense- i would expect the eyes to get red, swollen and itchy, more so than the body.

    anyway, if one is going to switch due to allergy concerns, it doesnt make sense to switch to a fluoroquinolone. so i think he should switch to tobrex. ask your doctor if he wouldnt mind that switch.

    it would be cool to give your child vigamox again, to see if he got the same hives–that would really settle the matter. but of course, i understand your reluctance!! as a father myself, its no fun making one’s child a guinea pig! (i do ask my adult patients to re-challenge themselves with the same drop in these situations- they typically agree, as they understand the worse that can happen is they get hives again for a couple of days)

  37. Mariana on March 21st, 2011 9:33 pm

    Dr. Weitzner,
    Thank you for the fast response. Since I insisted on switching the doctor prescribed polymyxin-B/trimethoprimophth solution. What do you think about this medication?

  38. ari weitzner on March 21st, 2011 11:15 pm

    also excellent choice

  39. amanda on April 5th, 2011 8:12 am

    Hello I have a question. I’ve been perscribed vigamox for a week and I’ve completed the weeks trial this past Sunday. I didn’t use the perscription Monday and as I wake up this morning I experienced a little bit of yellow discharge again. Now on Monday ..morning I didn’t experience this. It was actually the only morning I didn’t experience any discharge at all after waking up from a nights rest. Does this mean that I am relapsing already? Or is this normal since my eyes have been shut for about 5 hrs? I also have a sore throat and it has been like this for about a week now. It feels like a cold kind of but if it was a cold my sore throat should have stopped by now. I’m so confused, and I have no insurance with very low income so I don’t what to do. Please help me! Thank you so much.

  40. ari on April 5th, 2011 11:35 pm

    as i mentioned, conjunctivitis (except for sexually transmitted diseases) is a self-limited disease. it goes away regardless of treatment. if you are not a contact lens wearer, you probably have nothing to worry about. i cant say much about the sore throat.

  41. amanda on April 6th, 2011 7:31 am

    Thank you so much for your advice!

  42. Dawn on April 12th, 2011 10:12 am

    Thank you ahead of time for your time. My 10 month old had pink eye, then my 4 year old, then back to my 10 month old and then my husband. My children took the vigamox (my husband the sulfa drops) and were all much improved within days and healed by a week. I got something after they were all better. It started with waking up with one eye pink, swollen, and crusted shut. I started the sulfa drops and the next day woke up with both eyes that way. The sulfa drops burned terribly every time I put them in. My eyes were more red after every application so after 36 hours I started using gent drops. My eyes are much better but I have been on the gent drops for a week now and when I wake up my eyes are STILL pink and my vision is hazy-like. The pink and haziness clear up after drops and being awake for a while. I was only supposed to use the drops for 7 days but I’m almost afraid to stop using them. (BTW I’ve also been using Naphcon-A allergy drops to help with the redness.)

  43. Dawn on April 12th, 2011 10:22 am

    And now, I don’t know if this matters but my eyes are itchy were as for the last week they weren’t. Could I have something else going on other than pink eye? Should I continue the gent drops? And is it possible I’m still contagious after all this time? No real eye drainage in a week, more like “sleepy” in my eyes if anything. Sorry this has been going on in our house for over a month now and ready to turn the page on it. Thanks again.

  44. ari on April 12th, 2011 8:39 pm

    usually pink eye is contagious for about a week.
    rarely, conjunctivitis can irritate the eye for weeks or months. i dont think antibiotics are of any value at this point, but maybe steroid drops. im afraid you need to see an ophthalmologist at this point.

  45. Kel on April 28th, 2011 4:21 pm

    For about 5 months now, I’ve been having sore eye on and off. One week it would be my left eye, than a week or two later, it would be my right eye. It alternates back an forth. The symptom last from a day to a week, depending. I have not yet seen a doctor regarding this issue and just have used warm/hot tea bags and towels over my sore eye. It would start w/ either my upper or lower eye lid showing signs of pinkish than the soreness begins. Sometimes it swells a little bit and some mornings, there are the sticky stuff that makes my eye shut and can’t open. Sometimes there’s the flaky stuff on my eye and can make it hard to open as well, but just on the eye that is sore. I haven’t have any discharge, not that I can recall. But sometimes it does make a squeaking noise when I rub gently on the sore eye and then it would feel sticky. Maybe clear discharge after rubbing it. I wash my face w/ clean towels every night and sometimes wash my eyes with baby shampoo with warm water. I don’t even wear eye makeup.

    I don’t know if I should go see a doctor to prescribe my any antibiotic because reading the comments above about some of the prescription, I don’t know if I should or not. Besides, I don’t have really good health coverage right now. I pay full price for doctor’s visit and any lab work done. But if I have to go see a doctor, I will.

    I did have stye once last year and used the stye eye drop. It went away after a week, but a few months later, I started to develop the sore eyes. Any advice would be so helpful. Thanks.

  46. ari on April 28th, 2011 4:39 pm

    sounds like you have blepharitis, a common chronic condition of the lids. But you will have to see an ophthalmologist to get the correct diagnosis and treatment.

  47. Josh on April 28th, 2011 5:28 pm

    Dr. Weitzner,
    I totally agree with you about the over-use of the fluoroquinolones. It’s like pounding in a small finish nail with a sledge hammer! Great when needed, but feeding the share-holders otherwise. Have you considered a 5% opthal. betadine lavage for those suffering from EKC? It is what I use to treat my own kids. Its a little irritating initially, but shortens the duration to 1-2 days instead of a week or so. Off label, but very effective. Proparacaine, Betadine lavage for 1 minute, wiping lids as well, NSAIDS for comfort and Lotemax to reduce the inflammation. Your wife will then love you even more when the kids aren’t stuck at home!

  48. ari on April 28th, 2011 6:34 pm

    exactly right! i believe that in the third world, betadine drops are used for all kinds of conjunctivitis, and it works great- both bacteria and viral, and cheap as hell- pennies per dose. if my wife allows, i will use it on my kids!

  49. lorsan on May 3rd, 2011 2:30 am

    hi im having a pink eye now for about a week. my doctor prescribe me a vigamox,( 1 drop every 2 hrs )pred forte ( every 2 hrs)and a proifen (every 6 hrs) and since he cant speak english fluently i didnt have the chance to ask on how to do the dropping properly.. and im afraid of the side effects. is it always painful?

  50. lorsan on May 3rd, 2011 2:47 am

    and im just having red eyes no green discharge in my eyes.. just watery and a little painful :)

  51. ari on May 9th, 2011 9:29 am

    pink eye is not typically painful.
    you are taking quite a few drops for pinkeye! since you started them, you probably should finish. side effects are very rare.
    putting drops in the eye requires no special technique. just pull your lid down and squeeze. do it any way that you like.

  52. Amy on May 24th, 2011 10:41 pm

    Dear Dr. Weitzner,
    I read your above comments and I too have been diagnosed with pink eye. My left eye has been cloudy for almost two months and I wear contacts. I am guessing that this is why it has not cleared up on its own. I was prescribed Vigamox but told not to wear a lense in my left eye during treatment. My glasses are really out of date and I cannot stand to wear them. Am I asking for problems by continuing to wear contacts during treatment though I am using a new lense each day? Thanks so much!

  53. ari on May 31st, 2011 8:44 am

    yes-you are asking for problems if you wear contact lenses while being treated, but conjunctivitis rarely lasts more than a week or so. if you are still having issues, i urge you to get a follow up exam.

  54. Jen on June 12th, 2011 4:11 pm

    I’ve had recurring pinkeye on and off for about 2 months. It appears to be more viral than bacterial, but my doctor is doing cultures and I’m awaiting the results. He off-handedly mentioned that due to a swollen gland on the infected side, I may have chlamydia in the eye. I have been treated thus far with Tobradex and erythromyacin ointment to no avail. I’m now on Vigamox. My question is: Is there ANY way I may have caught chlamydia in the eye from another person, without sexual contact? Is it contagious for instance on surfaces, like other bugs? Also, to my knowledge I am currently STD-free although I will go in for testing just to be certain. Thank you…I am very worried as I wait for the results of the cultures.

  55. Dr. Ari Weitzner on June 12th, 2011 5:26 pm

    viral conj should not wax and wane. conj that lingers for months in a young, sexually active person is, in my book, chlamydia until proven otherwise. i agree with taking cultures, and you should be put on oral antibiotics like doxycycline for 2 weeks. i suppose it’s possible to catch chlamydia from non-sexual contact, but boy, that would be a rare bird. by the way, it’s not uncommon for the cultures to come back negative even though there is chlamydia there- so i like to treat with oral antibiotics anyway and if the patient is cured, i consider that a likely case- i leave it to the patient to deal with their sexual partner.

  56. Jen on June 13th, 2011 1:15 am

    Thanks for your response. The pinkeye has been pretty consistent in one eye for the last month. I am trying to figure out what could have happened. I’ve not had any sexual contact since my last (to my knowledge) monogamous relationship, and both he and I were tested (negative) for STD’s before any relations occurred (and we are both middle-aged). So if I am now positive somehow months after our breakup for chlamydia, I would of feel compelled to contact the ex-boyfriend, because it must mean he was also positive. But of course I don’t want to go through that if it’s at all possible I contracted it in some other way. I am really hoping it’s not an STD. The doctor also mentioned something about Cat Scratch disease, as I have been exposed to cat scratches from pets.

  57. Jen on June 13th, 2011 1:17 am

    I forgot to add: After my third full day of Vigamox 4x daily, the eye doesn’t seem to have improved too much…

  58. ari on June 13th, 2011 10:14 am

    you have ruled out chlamydia.
    the swollen gland is very suspicious for cat scratch, but it’s usually a self-limited disease and should be gone after a few weeks after your last exposure- unless you keep getting scratched (even tiny ones that you can barely notice).
    after weeks of treatment, i would doubt that more vigamox is going to help- this does not sound like a typical bacterial conjunctivitis. maybe it’s something in the tear duct? you may need a second opinion if this does not improve. 9i assume your cornea and anterior chamber are clear and therefore there is no suspicion of herpes)

  59. Jen on June 13th, 2011 11:22 am

    Yes…I just found out the chlamydia is ruled out. The urinalysis I went in for has just come back negative. So now I’m waiting for my eye culture results. He took several (six containers) and at least one is checking for viruses. I’ve had four eye doctors look at me over the course of the illness. I’ve asked about herpes and they have all brushed it aside.
    Now that I know it’s not an STD, I’m relieved but still perplexed. And yes, I have had repeated visble small scratches from playing with my cat, including one that caused a little blister that will not heal after several weeks. The Dr. prescribed a Z-Pak in case it’s Cat Scrach disease, but I’m waiting to start those meds until after I get the culture results. It looks like the Vigamox isn’t active against the Cat Scratch bacteria, as far as what I’ve read online.
    The main area of irritation is indeed next to my tear duct. I will ask him more about that if the cultures don’t reveal anything. And I will post here with the outcome.
    Thank you very, very much for your input.

  60. Rachel on July 4th, 2011 10:02 pm

    A few days ago my 2yr old son woke up with a runny nose. The next day it was a runny nose and a cough. I didn’t think much of it besides a common cold because his nose wasn’t mucousy, only clear. That is, until the next morning when his eye was glued shut with crust and mucous. So, I took him to the doctor. They told me he had an conjunctivitis eye infection, and prescribed him vigamox. The first time I used it, he developed red spots and bumps all over his face like hives. The second time I used it on him, the hives spread all over his body and lasted for about three hours. I haven’t used it again today, although it’s instructed to be used 3 times a day. Now I just don’t know what to do. His eye is cleared up for the most part, but he’s still has a cough and runny nose.

  61. ari on July 4th, 2011 11:21 pm

    a body rash would be pretty rare from a drop, so ordinarily i think you should call your doctor and get another drop. since he’s getting better, and it sounds like he had a cold in the eye (viral conjunctivitis), i doubt he needs anything anyway.

  62. Ivan on August 13th, 2011 8:25 pm

    Hello, I’m the type of person that rarely goes to the dr unless necessary. My daughter had pink eye for a week and she cleared up. Soon after I started w the symptoms 5 days ago and I bought similisan drops and didn’t help. Since my eye was red and area was mildly swollen I decided to visit the E.R on day 4, which was last night Aug 12 (the same day as day 4 my other eye began getting red but no swelling). Now I may also note that I had been working 12 hours all those days w roughly 5 hrs of sleep. I wear contacts but I immediately removed them when redness began. Now this is my question they injected me w a muscualr antibiotic and prescribed vigamox, keflex, and bactrim ds. I’m in bed resting it all off and have taken the meds and they feel good but is it safe to take that many antibiotics? Also how long after taking them can I expect to feel redness gone? Thanks ahead of time

  63. Dr. Ari Weitzner on August 13th, 2011 10:40 pm

    intramuscular antibx? very strange- not sure what to make of it. also, dont know why you are taking bactrim and keflex for mere conjunctivitis. i am not getting enough info here- doesnt make sense. something else is going on- maybe they suspect cellulitis?

  64. Mohamed Dukuly on August 14th, 2011 1:10 pm

    I accidentally used vigamox for nearly a month without realizing that only 7 days were described by my doctor. What will be my side effect if any ?. Please give me your professional advice as I am really concerned.

  65. Dr. Ari Weitzner on August 15th, 2011 9:57 am

    Without hearing more, I would say nothing to worry about, but as always in such situations, please consult your doctor.

  66. Bob on August 15th, 2011 4:44 pm

    Thank you doctor for all the information. I have recurring flare ups of red eye in my left eye. One ophthalmologist diagnosed herpes keratitis based on ulceration while at another time another doc diagnosed blepharitis. This current outbreak my GP has me on Vigamox and arithromycin based on swelling around the eye! Can one condition cause so many symptoms?

  67. ari on August 16th, 2011 8:57 am

    what do you mean by “so many symptoms”? all you state is “flare ups”.
    arithromycin is great for blepharitis, which typically waxes and wanes throughout life, and therefore needs life-long treatment. herpes keratitis is a very different disease- sometimes hard to diagnose after the acute event. perhaps you should see a cornea specialist for 1 more opinion.

  68. Ivan on August 16th, 2011 2:06 pm

    Ok. So I went to my doctor Monday morning and told him the same story about the e.r as I told u on Saturday. Was prescribed keflex bactrim and vigamox. According to the e.r doctor he didn’t like the fact that I had a fever of 101 and that my face looked a little swollen on my cheek area so he said that his evaluation was facial cellulitis w eye conjectuvitis. He didn’t do a culture test and I don’t know why but I did get that muscle injection antibiotic. Now on Monday morning I went to my regular doc and she told me he though I “may” have been coming down w cellulitis and he didn’t like the fact that I was starting a fever so she said he took an aggresive move to give me those medications. Although she also didn’t like the fact that I’m taking two oral antibiotics. She told me to discontinue the bactrim after day 5 and just continue the vigamox and keflex as noted. My eyes aren’t sore anymore and no itch and no gluey residue. I am also not affected to the light and they’re not pink more like a light pink and white. I feel I’m getting better and today the doctor said it was more than likely bacterial since the meds kicked in 4 days til major improvement. Do u agree w what she says? Also should I stop using the bactrim twice a day on day 5 like she says?

  69. Dr. Ari Weitzner on August 16th, 2011 10:44 pm

    hard to say. best advice at this point is to continue the keflex and vigamox for the full course.

  70. Mohd on October 11th, 2011 7:47 am

    i was diagnosed with viral pink eye, and the doctor gave me vigamox to use it every 2 hours for ten day, and a cream to put at night.. i didnt use it every 2 hours, i use it 4 times aday and For the first 5 days it got worse, i stoppped the cream and after two days it became better…then i went to the doctor again and he told me that im 70% ok but i should use the med 1 more week, so i put the cream again in the same night, and i woke up with pain and all redness and swollen came back again.. …
    By searching the net i found that there is no cure for and it should run it corse… So i will stop the all the med…..its day 10 now.. im so sadddd… Sorry about my english

  71. ari on October 15th, 2011 11:41 pm

    dont be sad. im sure you will be fine!

  72. carol on November 5th, 2011 6:08 pm

    My Grandson stuck a stick in his eye and and is going to have to have cataract surgery.The emergency doctors glued the cut on his eye and prescribed vigamox every two hours around the clock. He is five years old and it is becoming difficult to wake him in the middle of the night to administer the drops. Do you think using the drops every two hours until he falls asleep is okay. Or should we continue to wake him during the night?

  73. ari on November 6th, 2011 9:19 am

    off the record i would say its probably not necessary to wake him up, as there is no good evidence that antibiotic drops really can prevent infection inside the eyeball from a foreign body. why not just put a few drops on the inner corner of his eye as he lays flat, then gently lift his eyelid just slightly- the medicine will fall right into his eye. i advise this to all my patients, young or old, who have trouble taking drops. it’s wasteful, but it works.

  74. Lauren R. on December 15th, 2011 2:05 pm

    Pink Eye has been going through my childrens school for the past 2 months – My first 2 children had it last month and it cleared up within 24 hours on AK-TOB drops. (I continued the drops 3x a day for 5 days as prescribed). My third child has it now and it is so much worse – eye swollen shut! I started her on the refill of AK-TOB yesterday that I had filled and called my doctor thinking that the bacteria is simply getting resistant to the drops since it has been passed to over 100 children in the school. He prescribed Moxeza. She has now had 1 dose of AK-TOB and 2 doses of Moxeza – which one is better and which should I continue using?

  75. ari on December 15th, 2011 5:15 pm

    i am not familiar with moxeza. if the eye is so swollen shut, i would see an ophthalmologist

  76. Saph on January 2nd, 2012 8:50 am

    Sorry but I disagree, there are few body parts I don’t like to gamble with, one of them being the eye. I’d rather have a “superdrug” over an “oldie but goodie” for almost anything anyway. The concept of saving 60-70 dollars on something as important as your health, specially your eyes, is somewhat backwards to me. Forgo the extra clothes, going out, or anything else and get the medicine please. Yeah we’re on a recession but 90 bux is what we spend at the movies or any restaurant these days, it’s not world shattering money.

    Just the opposite, if I go to the doctor and he prescribes me something and later I find out there was a more expensive and better option an he didn’t even give me the choice I would be downrating him on md reviews and really angry and have had a doctors office refund me exam and med. A doctor prescribed me sulfa once, I asked for something else…

  77. Dr. Ari Weitzner on January 2nd, 2012 11:38 am

    i respectfully, and in strong terms, disagree. a doctor who answers like this on his boards would fail immediately. no infectious disease doctor thinks like this, and all they do all day is teach doctors just the opposite. in fact, it is precisely this kind of thinking which leads to resistance among “superdrugs” and created the disaster of mrsa and other bugs that we just cant kill, and so people die. especially in conjunctivitis, which goes away whether you treat it or not (i dont even treat my own children), it is plain silly and wasteful to use a superdrug. it would no different that using a superdrug after you pop a zit- thats how silly it is. of course, in serious infections, the infectious disease doctors will urge superdrugs. but in order for superdrugs to remain “super”, your thinking must be rejected. its not just cost (and cost is important, for there are only “x” dollars, and if you waste it on superdrugs, there wont be enough money for other important things). using superdrugs when not truly necessary is just plain bad medicine and increases the odds of resistance.

  78. Mary on January 3rd, 2012 10:59 pm

    Dr. Weitzner,

    I’m a 39 year old female. I was exposed to someone who had pink eye December 25th. He was prescribed Gentamicin Sulfate and I never saw him again until January 1st his eye looked normal and this is why he was able to get together with his friends for new year’s day. Before I even saw my friend I had develop a sore throat at the time I thought it was just a cold coming but it never changed. Yesterday although I was still having lots of pain I went snowboarding. I was sweating very much and the temperature was very low. Once I got home I took a hot shower and realized my right eye was a bit pink. I thought it was maybe just the shampoo or the steam for the shower and I didn’t think much about it. This morning I woke up with my eye shut close and a clear discharge all over it. I was afraid I might have hit my eye somehow snowboarding. I was not wearing eye protection and thought maybe the snow blowing straight to my face hit my eye causing the redness. My left eye by now also has clear discharge. I do not have any itching or pain. My eyes are not swollen but they are irritated from me cleaning them over and over. I currently do not have insurance but I do have recent medicine prescribed to me from when I had Lasik surgery about six months ago. I checked the date on the drops and they are still good. I have Vigamox .05 and Omnipred eyes. I know you would not normally prescribed Vigamox but it’s all I have now. My questions are the following, do you think I could use both drops? and how often? Is there anything over the counter I can buy to help me. I’m also afraid of getting better and getting contiguous again from touching something around the house I have touch and its infected. How long can the virus or bacteria live on things? Someone had also mentioned that maybe what I have it related to my sore throat. Can this be possible? It’s my first time I have ever had what I think is “pink eye”. Thank you for any insight you can provide me with.



  79. Mary on January 3rd, 2012 11:30 pm

    I forgot to mentioned I also have Tobradex ointment. I researched online and I believe is used for pink eye. I do not how often I should apply it or if I should use something else.


  80. ari on January 5th, 2012 9:14 am

    looks like you have typical viral conjunctivitis- the sore throat certainly suggests it. i would leave it alone. you are contagious for about a week. i dont know how long the virus can survive on surfaces- but typically, it is spread via hand to mouth, and we advise not to share towels or pillowcases. we dont catch disease by by sweat or heat or cold. its the virus.

  81. Terec on January 11th, 2012 12:37 pm

    I would disagree about waiting two weeks. I waited a week for my son, and he almost wound up with permanent vision loss. He ended up with the strep causing bacteria in his eye. He had blisters on his retina when I finally took him to the eye doctor. Two days of Vigamox and he looked 100% better. I’m so happy my optometrist treated his symptoms aggressively. She’s the best!

  82. ari on January 11th, 2012 1:32 pm

    You can’t possibly mean blisters on retina. Maybe you meant on conjunctiva or cornea? Strep invading retina would mean your child was admitted to the ICU. Cerainly would not treat strep invasion of retina with vigamox drops- it would absolutely mean IV antibiotics, again probably in the ICU, and it most certainly would not resolve in a couple of days.
    I also treat conjunctivitis when I suspect its bacterial. We all do. The issue here is treating what looks and smells like viral conjunctivitis, which good doctors know is a bad idea and only increases odds of more resistant oranisms we CAN’T treat.

  83. Tricia on January 20th, 2012 8:45 pm

    My 5 year old is c/o that her eyes are itchy and they burn. I have noticed her eyes are red with a thick yellow drainage that looks like pus. Her eyes also stick together. She doesn’t c/o of any blurred vision or vision changes except when she looks at bright lights. The pain is not too bad. She has no other complaints but does go to day care a few days a week where there are other kids who have had similar symptoms. Is this bacterial conjunctivitis (pink eye)? What would you prescribe and how long should I keep her out of daycare? What are some other alternative medications? How can I comfort her and provide infection control besides handwashing? Thank you.

  84. Kelly on January 23rd, 2012 10:09 pm

    My 6 year old has pinkeye and was prescribed sulfacetmide na 10% and has been taking for 3 days her eyes are less red and still a bit crusty when can she return to school ?

  85. ari on January 24th, 2012 10:06 am

    if it looks like pus, it is likely bacterial and should be treated with antibiotic drops. i would keep her away from daycare for about a week. hand-washing is best way to control spread.

  86. JLS on January 30th, 2012 1:50 am

    About a month, or so, ago, I came down with conjuntivitis, and was prescribed a course of polymyxin-b/trimethoprimopth solution. 1-2 drops every 4-6 hours for five days. By day 4, it burned like acid to put it in my eye. On day 5, there was no improvement. I self administered for another two days, just in case. No improvement.
    Returned to clinic, was reassessed, and given ofloxacin. Instill two drops four times daily, for five days. Within 24 hours, there was a 85% improvement, significant reduction in redness, no itching, and no discharge to speak of. By day five, improvement had reached about 95%. Remained on treatment another two days, but the symptoms have gotten worse. Itchy, light swelling, redness, a whitish, stringy, sticky discharge. No ear issues, no throat issues.
    Any thoughts on what the next treatment might be?

  87. kris on February 3rd, 2012 2:15 am

    I’ve read through the comments and appreciate all the info, but I was wondering if oral antibiotics are also neccesary for a 20 month-old if the pink eye (began 5 days ago and consists of redness and swelling around the eye and moderate yellow thick drainage) seems to be associated with occasional fever, sore throat, nasal drainage, and pulling at the right ear. She had a cold with nasal symptoms and fussiness prior to the pink eye developing. The fever was first noted 1 day after the red pussy eyes and she began pulling at her right ear and speaking with a hoarse voice 3 days later. She seems to get 4-5 colds each winter (this is her 2nd so far this winter) and they often include pulling at ears, but never much of a fever. She has never been on any medications, and I’d rather not have her take oral antibiotics if they are not needed. We are keeping her eyes clean with warm washcloths an needed (approx 6 times per day) but her eyes are worse everyday. I am also debating whether to take her to the eye doctor or to the NP who has done her well child exams.

  88. ari on February 3rd, 2012 9:44 am

    oral antibiotics a good idea in a 20 month old if the conjunctivitis looks bad and may be spreading to the lids. it also sounds like baby has ear infection- for that, antibiotics typically have little efficacy according to an important article that came out a couple of years ago,..

  89. misty on February 18th, 2012 7:20 pm

    My son developed a low grade case of pink eye, both eyes were pink and had crust in the corners, and slimy crust on his eyes, i called the Pediatriacian the day i saw it come on. he gave him 1 Rx: Polymyxin B Sulfate and Trimethoprim Ophthalmic solution. his eyes seemed to clear up in the next 2 days!all gone!! My pedi said it should be all clear in 2 days wich it was… But 5 days later one of his upper eye lids swelled up and puffiness around the bottom, and i started given him the drops again bc i thought maybe its was somthing with the pink eye again and now the next day his other eye is swollen, so now both eyes are swollen. Do u you know whats going on? do u know why 1 eye reacted a day after the other?

  90. ari on February 19th, 2012 10:58 am

    you should not have stopped treatment after 2 days for a presumed bacterial infection. otherwise, you just kill off the weaker, susceptible bacteria, while the stronger ones thrive and are harder to kill. as a general rule in medicine, one needs to treat an infection for at least 7 days, even if it looks all better.
    sounds like your child simply had a recurrence after inadequate treatment. why 1 eye takes a day longer than other- no good reason. re-start the drops and take for a full week and go back to ophthalmologist if not getting better.

  91. Nikki on February 27th, 2012 3:05 pm

    How soon can a child return to school after starting Moxeza? I had a healthcare provider state that after one dose the child can return to school–and said there is research to support this. Any thoughts?

  92. ari on February 28th, 2012 9:47 am

    for viral conjunctivitis, we typically keep kids out of school for a week. for bacterial, i usually allow them to return when the discharge stops. i am not familiar with any research on this.

  93. Joan on March 7th, 2012 7:55 pm

    Put in new contacts with new solution @ 630 am. By 10 am right eye red. Took contacts out. By 4 pm had yellow discharge from left eye. I keep seeing references to contact lens wearers with all bets off? I just started Vigamox but am wondering if as a contact lens wearer I should do more? Also could the lens or solution been contaminated? Just opened but the infection was so rapid!
    Thanks for your response.

  94. Dr. Ari Weitzner on March 11th, 2012 11:31 am

    likely a reaction to new solution- go back to your old brand.
    a red eye in a contact lens wearer can be serious- use vigamox every 15 min for 6 hours, the every hour, and see an ophthalmologist very soon, like today or tomorrow.

  95. Nikki on March 18th, 2012 8:57 am

    Very thankful to be able to ask this question. My 9 year old son woke up with crusty, very red eyes. It was Saturday (pedi closed) so I started vigamox I had on-hand (new bottle). Twenty four hours later his eyes are still exceptionally red and crusty again when he woke up. They look even worse.

    I have 3 boys and we’ve had pink eye over the years, and this looked the same initially. But today his eyes are even redder and angrier-looking, than I’ve ever seen in my kids. I cleaned the crustiness off his eyes with warm water/cloth, and did more drops.

    Does this sound viral? In the past, vigamox always cleared up the infection in a day or so. It’s scary to see his eyes so red. I’m thinking I will take him to the urgent pedi care today when they open.

    It’s freaking me out a bit if there’s nothing that can be done. I’m washing/cleaning like crazy- is it possible that my other kids won’t get it? I keep reading how contagious it is. Eek! Thank you for your insight.

  96. ari on March 19th, 2012 9:50 am

    since you started the vigamox, continue 4 times a day. if not a lot better by tomorrow, go to ophthalmologist.

  97. Louise on March 26th, 2012 8:44 pm

    Is it really unsafe to use Vigamox after the 28 day expiration?

  98. ari on March 29th, 2012 9:39 am

    expired medicines are not unsafe- just slightly less effective.

  99. Shreya on April 14th, 2012 3:13 pm

    Hi this is very informative. I have gotten pink eye since two days. First day it was red and with lot of yellow-green discharge and i used naphazoline drops to get rid of redness. I dint have runny nose or sore throat. Second day i felt some throat irritation with less discharge and very less redness. I used zaditor from second day. On third day, sore throat cleared up, no discharge, very less redness but my pain on eyelids started. I do not want the extreme treatments and this is why i am asking you here. Should i see dr?

  100. Shreya on April 14th, 2012 3:15 pm

    Forgot to mention, claritin that i started taking from first day and i suspect pollen allergy but previously i got watery eyes but never conjunctivitis due to pollen.

  101. 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?

  102. 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.


  103. 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.

  104. 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

  105. 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.

  106. 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

  107. 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.

  108. 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.

  109. 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.

  110. 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!!!

  111. 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

  112. 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 :)

  113. 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!

  114. 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!

  115. 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

  116. 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.

  117. 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.

  118. 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.

  119. 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.

  120. 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.

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

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

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

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

  123. 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.

  124. 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.

  125. 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.

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

    expiration means little. give it a few more days.

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

    I will, thank you.

  128. 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?

  129. 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?

  130. 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

  131. 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?


  132. 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

  133. 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.

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

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

  135. 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

  136. 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.

  137. 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?

  138. 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.

  139. 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?

  140. 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

  141. 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!

  142. 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.

  143. 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).

  144. 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.

  145. 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.

  146. 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.

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

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

  148. 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.

  149. 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

  150. 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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