Conjunctivitis Protocols for Returning to School Are Inconsistent Across States

Some states lack policies for returning to school following conjunctivitis infection, and some require antibiotic treatment regardless of the nature of infection.

Policies regarding a return to school following conjunctivitis infection are often inconsistent across states, according to research published in the Journal of  the American Association for Pediatric Ophthalmology and Strabismus.

Investigators searched state websites and contacted officials to identify state policies regarding disposition and diagnosis of students with conjunctivitis. They noted a wide variation in policies from state to state with some states not having any requirements in place at all.

The team noted that 15 states had no official online policy, 10 allowed students to remain in school, 5 allowed a return to school following treatment with antibiotics, 5 required clinician approval before returning, and 17 lacked details and internal consistency. Among the states, only 12 offered policies that were thoroughly presented with Hawaii’s policy being the most detailed, according to the report. Overall, 23 of the states refer to governmental sources such as the Centers for Disease Control and Prevention (CDC) or the American Academy of Pediatrics (AAP).

The researchers suggest that the AAP, American Association for Pediatric Ophthalmology and Strabismus, and American Academy of Ophthalmology craft a policy to inform state and local policies and guide providers in managing conjunctivitis. They assert that doing so will prevent severe outbreaks, limit student absences, and address inconsistencies concerning the use of antibiotics. Collaboration could aid epidemiologic monitoring of infectious conjunctivitis, they argue.

“Accessible information on distinguishing noninfectious from infectious etiologies and viral from bacterial causes, and care for both, such that antibiotics are not a requirement for return to school, would be helpful, as would ways to prevent spread, including clarification of what constitutes ‘close contact’ as in the CDC’s recommendation for excluding infected students,” according to the investigators.

The research was limited by a failure to verify online policy with each state.


Lee T, Kuo IC. Survey of state conjunctivitis policies for school-aged students. J AAPOS. Published online April 1, 2022. doi:10.1016/j.jaapos.2022.02.002