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 subconjunctival hemorrhages may be present
- Preauricular lymphadenitis (adenovirus)
Evaluation
Conjunctivitis with limbus sparing
- 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 |
Differential Diagnosis
Management
- Artificial tears 5-6x per day
- 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
See Also
References
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