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Invited Commentary
April 1, 2021

Keeping Red Eyes From Putting Workplaces in the Red

Author Affiliations
  • 1W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
  • 2Center for Eye Policy and Innovation, University of Michigan, Ann Arbor
  • 3Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor
JAMA Ophthalmol. Published online April 1, 2021. doi:10.1001/jamaophthalmol.2021.0144

Adenoviral conjunctivitis disrupts workplaces, schools, and communities, costing hundreds of millions of dollars annually. With no proven treatment and the potential for rapid spread, vision-threatening complications, and prolonged recovery, employers must take its identification and containment seriously. Meanwhile, this condition frequently presents a diagnostic dilemma, with a wide range of less contagious or treatable conditions masquerading as viral conjunctivitis. This leads to several undesirable scenarios, including the unnecessary furlough of employees who come to work with red eyes and inappropriate prescription of topical antibiotics, which can contribute to antibiotic resistance, to satisfy school, daycare, or workplace guidelines requiring 24 hours of antimicrobial therapy before a student or worker can be cleared to return. Both approaches reflect conventional guidance aimed at trying to limit contagion and absenteeism in a setting of diagnostic uncertainty.1 However, with precise diagnostic tests, such as polymerase chain reaction (PCR) testing, available, it should be possible to distinguish between patients with and without adenoviral conjunctivitis and alleviate much of this uncertainty.

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