A patient with copious purulent eye discharge who wears contact lenses should be treated with which therapy?

• A. Warm compresses
• B. Ciprofloxacin drops
• C. Olopatadine
• D. Erythromycin drops

Answer: (B)

The situation points to bacterial conjunctivitis, given the purulent discharge. In someone who wears contact lenses, there’s a real concern for Pseudomonas infection, which can be more aggressive and involve the cornea. A topical fluoroquinolone, such as ciprofloxacin drops, provides strong coverage against Pseudomonas as well as other common ocular pathogens, making it the most reliable option to treat this presentation promptly and reduce the risk of complications.

Warm compresses and lid hygiene are helpful for comfort and lid disease but won’t adequately treat an active bacterial infection with purulent discharge. Olopatadine is an antihistamine used for allergic conjunctivitis and would not address an infection. Erythromycin drops cover many Gram-positive bacteria but have limited activity against Pseudomonas, making them less suitable for a contact lens–associated bacterial conjunctivitis.