Background and aetiology
- Very common cause of red-eye, commonly caused by adenovirus
- Risk factors include recent upper respiratory tract infection
- Usually has a longer course than bacterial conjunctivitis (12-21 days cf 7-10 days) and is highly contagious.
- Rarer viral causes include herpes simplex (generally more problematic disease- follicular conjunctivitis)), as well as varicella zoster, HIV and influenza.
- Gritty/uncomfortable eyes (may be one, commonly both)
- Watery discharge
- Associated cough/cold
- Recent association with someone with ‘pink/red eye’
- Red eye with diffuse conjunctival injection
- Clear discharge
- Small, white, lymphoid aggregates may be present on the conjunctiva (viral follicles)
- Small, focal areas of corneal inflammation with erosions and associated opacities may give rise to pronounced symptoms
- Special cases
- Primary ocular HSV mainly affects young children/infants and presents with a red, irritated, watery eye. Often the eyelid is also affected with multiple vesicular lesions which can be painful too.
- As with bacterial conjunctivitis, viral conjunctivitis is usually self-limiting and self care (particularly with hygiene and reducing the spread of disease) is all that is recommended.
- Again, lubricating eye drops may be of benefit.
- In rare cases where corneal lesions are severe/persistent, steroid drops may be used, but only with ophthalmology supervision, as this carries significant risk of complications (which could ultimately be blinding)