Viral conjunctivitis

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

Diagnosis

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

DDx

Eye Algorithm (Main)

Treatment

1. Artificial tears 5-6x per day
2. Cold compresses
3. Consider topical abx 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

• Conjunctivitis

Epidemic Keratoconjunctivitis

Background

• Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
• Caused by certain types of adenovirus

Clinical Features

• Usual symptoms of viral conjunctivitis plus:
  • Foreign body sensation
  • Multiple corneal infiltrates
  • Decreased visual acuity

Treatment

• Referral to ophthalmologist to confirm dx and decide if pt requires course of steroids

Source

• Tintinalli
• Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.