[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Ophthalmology](https://durgical.com/en/ophthalmology/) › [Ophthalmic drugs and toxicity](https://durgical.com/en/ophthalmology/areas/drugs/) › Topical antibiotics for the eye

# Topical antibiotics for the eye

- Drugs and toxicity

Antibiotic drops shorten bacterial conjunctivitis and protect abrasions; keratitis needs cultures and intensive drops from ophthalmology.

Updated Nov 5, 2026

**See it in 3D:** [Cornea](https://durgical.com/en/anatomy/cornea/)

## Key points

- Bacterial conjunctivitis: short topical course.
- Contact lens wearer: fluoroquinolone (Pseudomonas).
- Keratitis = culture and intensive drops by ophthalmology.
- Viral conjunctivitis: no antibiotics.

## What it is

Topical antibiotics are used for bacterial conjunctivitis, to prevent infection of corneal abrasions and after eye surgery, and intensively for bacterial keratitis. Bacterial conjunctivitis is often self-limiting; antibiotics shorten it and allow earlier return to school or work. Keratitis is a different problem: it needs a culture and frequent, often fortified, drops under ophthalmology.

## What to know

- Common classes: chloramphenicol, aminoglycosides (tobramycin, gentamicin), fluoroquinolones (moxifloxacin, ciprofloxacin, ofloxacin), macrolides (azithromycin, erythromycin ointment).
- Fluoroquinolones are preferred for contact lens wearers because they cover Pseudomonas.
- Ointments last longer and suit children and night use; drops are better during the day.
- Aminoglycosides can be toxic to the corneal epithelium with long use.

## Toxicity and risks

- Viral conjunctivitis, the most common type, does not respond to antibiotics.
- Neonatal, gonococcal and chlamydial conjunctivitis need systemic treatment.
- Antibiotic-steroid combinations should be left to ophthalmology.

## Next step / Initial management

- Uncomplicated bacterial conjunctivitis: hygiene and a short course of a broad-spectrum topical antibiotic; review if not better in a few days.
- Corneal abrasion: prophylactic topical antibiotic until healed; a fluoroquinolone if the patient wears contact lenses.
- Corneal infiltrate or ulcer: same-day ophthalmology for culture and intensive treatment.
- Avoid prolonged or repeated courses without a diagnosis.

## Test yourself

Think of the answer, then tap the question to see it.

## Which topical antibiotic class is preferred in a contact lens wearer with an abrasion?

A fluoroquinolone, because it covers Pseudomonas.

## Does viral conjunctivitis respond to antibiotics?

No; it is managed with hygiene and comfort measures.

## How is bacterial keratitis managed differently from conjunctivitis?

With same-day ophthalmology, corneal culture and intensive, often fortified, antibiotic drops.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/ophthalmology/topical-antibiotics-for-the-eye/)

## Connections

## See it in 3D 1

The structures of Durgical's 3D anatomy where it is found.

- [Cornea](https://durgical.com/en/anatomy/cornea/)

## Related 4

- [Red eye: what is serious and what is not](https://durgical.com/en/ophthalmology/red-eye-what-is-serious-and-what-is-not/)
- [Red eye in a contact lens wearer](https://durgical.com/en/ophthalmology/red-eye-in-a-contact-lens-wearer/)
- [Corneal and subtarsal foreign bodies](https://durgical.com/en/ophthalmology/corneal-and-subtarsal-foreign-bodies/)
- [Neonatal conjunctivitis and its prevention](https://durgical.com/en/ophthalmology/neonatal-conjunctivitis-and-its-prevention/)

## Related conditions 3

- [Conjunctivitis](https://durgical.com/en/conditions/conjunctivitis/)
- [Keratitis and corneal ulcer](https://durgical.com/en/conditions/keratitis-and-corneal-ulcer/)
- [Corneal abrasion and ocular foreign body](https://durgical.com/en/conditions/corneal-abrasion-and-ocular-foreign-body/)

## In Pharmacology 8

- [Chloramphenicol](https://durgical.com/en/pharmacology/chloramphenicol/)
- [Tobramycin](https://durgical.com/en/pharmacology/tobramycin/)
- [Gentamicin](https://durgical.com/en/pharmacology/gentamicin/)
- [Moxifloxacin](https://durgical.com/en/pharmacology/moxifloxacin/)
- [Ciprofloxacin](https://durgical.com/en/pharmacology/ciprofloxacin/)
- [Ofloxacin](https://durgical.com/en/pharmacology/ofloxacin/)
- [Azithromycin](https://durgical.com/en/pharmacology/azithromycin/)
- [Erythromycin](https://durgical.com/en/pharmacology/erythromycin/)

[← All of ophthalmology](https://durgical.com/en/ophthalmology/)

Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once.

Sources: [Bacterial Conjunctivitis](https://www.ncbi.nlm.nih.gov/books/NBK546683/) (StatPearls Publishing (NCBI Bookshelf), 2026); [Bacterial Keratitis](https://www.ncbi.nlm.nih.gov/books/NBK574509/) (StatPearls Publishing (NCBI Bookshelf), 2023).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/ophthalmology/topical-antibiotics-for-the-eye/