Viral conjunctivitis


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

Clinical Features

Conjunctivitis with limbus sparing
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
  • 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


  • 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


  1. Artificial tears 5-6x per day
  2. Naphazoline/pheniramine 0.025%/0.3% drops 4x daily
  3. Cold compresses
  4. Consider topical antibiotic if unable to differentiate from bacterial conjunctivitis
  5. Frequent hand-washing (highly contagious)


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

See Also