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
Conjunctivitis DDX
Treatment
- Artificial tears 5-6x per day
- Cold compresses
- Consider topical abx 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
See Also
Epidemic Keratoconjunctivitis
Background
- Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
- Vision-threatening
- Caused by adenovirus infection that is highly contagious and tends to occur in epidemics
Clinical Features
- Often preceded by cough, high fever, malaise, myalgias, N/V
- Usual symptoms of viral conjunctivitis plus:
- Foreign body sensation
- Photohobia
- Chemosis
- Papillae of inf palpebral conjunctiva
- Ipsilateral preauricular LAD
Diagnosis
- Slit Lamp
- Diffuse, superficial keratitis but no corneal ulceration
Treatment
- Artifical tears
- Cool compresses
- Cycloplegics if photophobia is severe
Disposition
- Referral to ophthalmologist to confirm dx and decide if pt requires course of steroids
Source
- Tintinalli
- Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am 2008;26