Which symptom would warrant a referral in cases of conjunctivitis?

A referral for further evaluation in cases of conjunctivitis is warranted when there is reduced vision. This symptom may indicate a more serious underlying condition that could lead to permanent impairment if not addressed promptly. While conjunctivitis typically causes symptoms such as redness, tearing, and often itchiness due to irritation and inflammation of the conjunctiva, reduced vision can signal complications, such as corneal involvement, which may lead to vision loss if not treated appropriately.

Other symptoms, like crusting in the eye, itching, tearing, or swelling of the eyelids, are commonly associated with conjunctivitis but do not necessarily indicate the presence of a critical condition. These symptoms can often be managed with topical medications and do not typically impair vision. Therefore, they do not usually necessitate an urgent referral unless accompanied by other concerning signs or symptoms.