Viral conjunctivitis

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Typical Viral Conjunctivitis

Background

  • Most common cause of infectious conjunctivitis
  • Often preceded by URI (usually adenovirus)

Clinical Features

  • Complaint of "red eye" with mild-moderate, watery discharge
  • Usually painless unless there is some degree of keratitis
  • Often one eye will be involved initially with other eye involved within days
  • Unilateral or bilateral conjunctival injection with perilimbal sparing
  • Chemosis and subconj hemorrhages may be present
  • Preauricular lymphadenitis (adenovirus)

Evaluation

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Conjuctivits with limbus sparing
  • Slit Lamp
    • Follicles on inferior palpebral conjunctival
    • Mild, punctate fluorescein staining of cornea (occasional)
      • Must differentiate from herpetic dendrite

Clinical diagnosis of conjunctivitis

Conjunctivitis
Bacterial Viral Allergic
Bilateral 50% 25% Mostly
Discharge Mucopurulent Clear, Watery Cobblestoning, none
Redness Yes Yes Yes
Pruritis Rarely Rarely Yes
Additional Treatment: Antibiotics Treatment: Hygiene Seasonal

Differential Diagnosis

Conjunctivitis Types

Management

  1. Artificial tears 5-6x per day
  2. Cold compresses
  3. Consider topical antibiotic if unable to differentiate from bacterial conjunctivitis
  4. Frequent hand-washing (highly contagious)

Disposition

  • Follow-up with ophtho if worsening or no improvement in 7 days

See Also

References