Viral conjunctivitis: Difference between revisions
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==Background== | |||
*Most common cause of infectious conjunctivitis | *Most common cause of infectious conjunctivitis | ||
*Often preceded by URI (usually adenovirus) | *Often preceded by [[URI]] (usually [[adenovirus]]) | ||
==Clinical Features== | |||
*Complaint of "red eye" with mild-moderate, watery discharge | [[File:Conjunctivitis.jpg|thumb|Conjunctivitis with limbus sparing]] | ||
[[File:Conjunctivitis disease.jpg|thumb|Viral conjunctitivis lateral view with limbus sparing.]] | |||
*Complaint of "[[red eye]]" with mild-moderate, watery discharge | |||
*Usually painless unless there is some degree of keratitis | *Usually painless unless there is some degree of keratitis | ||
*Often one eye will be involved initially with other eye involved within days | *Often one eye will be involved initially with other eye involved within days | ||
*Unilateral or bilateral conjunctival injection with perilimbal sparing | *Unilateral or bilateral conjunctival injection with perilimbal sparing | ||
*Chemosis and | *Chemosis and [[subconjunctival hemorrhage]]s may be present | ||
*Preauricular [[lymphadenitis]] (adenovirus) | |||
=== | ==Differential Diagnosis== | ||
*Slit | {{Conjunctivitis DDX}} | ||
==Evaluation== | |||
*[[Slit lamp]] | |||
**Follicles on inferior palpebral conjunctival | **Follicles on inferior palpebral conjunctival | ||
**Mild, punctate fluorescein staining of cornea (occasional) | **Mild, punctate fluorescein staining of cornea (occasional) | ||
***Must differentiate from herpetic dendrite | ***Must differentiate from herpetic dendrite | ||
{{Clinical diagnosis of conjunctivitis}} | |||
{{ | |||
== | ==Management== | ||
#Artificial tears 5-6x per day | #Artificial tears 5-6x per day | ||
#Naphazoline/pheniramine 0.025%/0.3% drops 4x daily | |||
#Cold compresses | #Cold compresses | ||
#Consider topical | #Consider topical antibiotic if unable to differentiate from bacterial conjunctivitis | ||
#Frequent hand-washing (highly contagious) | #Frequent hand-washing (highly contagious) | ||
==Disposition== | |||
*Follow-up with ophtho if worsening or no improvement in 7 days | *Follow-up with ophtho if worsening or no improvement in 7 days | ||
==See Also== | |||
*[[Conjunctivitis]] | *[[Conjunctivitis]] | ||
*[[Eye algorithms (main)]] | |||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:ID]] | [[Category:ID]] |
Latest revision as of 16:41, 12 March 2021
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 subconjunctival hemorrhages may be present
- Preauricular lymphadenitis (adenovirus)
Differential Diagnosis
Conjunctivitis Types
Evaluation
- Slit lamp
- Follicles on inferior palpebral conjunctival
- Mild, punctate fluorescein staining of cornea (occasional)
- Must differentiate from herpetic dendrite
Clinical diagnosis of 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 |
Management
- Artificial tears 5-6x per day
- Naphazoline/pheniramine 0.025%/0.3% drops 4x daily
- Cold compresses
- Consider topical antibiotic if unable to differentiate from bacterial conjunctivitis
- Frequent hand-washing (highly contagious)
Disposition
- Follow-up with ophtho if worsening or no improvement in 7 days