Viral Conjunctivitis

Symptoms

Possible symptoms of viral conjunctivitis include unilateral or bilateral redness, itching, burning, eye tearing, a foreign body sensation, lymph node swelling, and bleeding. It is often accompanied by inflammation of the cornea (keratitis). Itching, watery eyes, bilateral findings and other allergic symptoms indicate allergic conjunctivitis. However, differentiation based on clinical signs is generally difficult (see below).

Causes

The disease is based on a viral infection of the anterior segment of the eye. The causative agent is often identified as the highly contagious adenoviruses, which can cause a concurrent cold. Another important causative agent is the herpes simplex virus, which often affects the cornea in recurrences (herpes simplex keratitis). Other possible causes:

  • Varicella zoster virus
  • Epstein-Barr virus
  • Measles virus
  • Rubella virus
  • Molluscum contagiosum virus
  • Papillomaviruses
  • Influenza viruses

Enterovirus 70 and coxsackie A24 cause acute hemorrhagic conjunctivitis. See also under epidemic conjunctivitis.

Diagnosis

The diagnosis is made in ophthalmologic care. Differentiation from other causes of conjunctivitis is difficult and only inadequately possible based on clinical signs. Possible differential diagnoses include allergic conjunctivitis, bacterial conjunctivitis, and nonspecific eye irritation. Concurrent cold symptoms suggest a viral cause.

Nonpharmacologic treatment

Good hygiene measures are important to prevent further infection: use separate towels or paper towels, avoid contact with the eyes and other people, and wash or disinfect hands frequently and well. Because of the high risk of infection, patients should stay home and not go to work or school while they are contagious.

  • Cleaning the eyes with black tea compresses.
  • Wash out eyes with sterile saline solution
  • Eye bath

Drug treatment

Treatment is controversial and has little evidence base. In practice, antibiotic eye drops are often used, but these are not effective against the viral cause of the disease and are intended to treat bacterial conjunctivitis. Antiviralia:

Tear substitutes:

  • And eyebright preparations can symptomatically relieve the symptoms.

Vasoconstrictors:

  • Local sympathomimetics contract the vessels and take the red out of the eyes. They can relieve symptoms symptomatically, but should be used only for a short time.

Glucocorticoid eye drops:

Disinfectants: