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 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