Viral Conjunctivitis

Description of the disease

This is an inflammation of the eye’s conjunctiva (conjunctivitis) (the conjunctiva covers the inner surfaces of the upper and lower eyelids and the front part of the eyeball up to the cornea, but not the cornea itself), caused by viruses, most commonly types 3, 8, and 19 of adenoviruses, less frequently herpes conjunctivitis.

Symptoms

Usually, one eye is affected, but both can be involved. Typical symptoms include redness, swelling, itching, burning, sensation of a foreign body, watery discharge from the eye (tearing), and no vision impairment.

Herpetic conjunctivitis is caused by Herpes simplex types 1 and 2 (in adults), Herpes zoster (in newborns). Typically, one eye is affected, with blisters forming in the conjunctiva of the eye, along the edges of the eyelids, and on the affected side of the face skin.

When conjunctivitis is caused by adenovirus type 3, along with eye involvement, there is also inflammation of the throat (pharyngitis) (adenopharyngoconjunctival fever). Such adenovirus can cause an epidemic, and the affected individual (often a child) must be isolated from others for 2 weeks. In this type of conjunctivitis, there is swelling of the neck lymph nodes, the formation of follicles in the conjunctiva (lymph nodes), and an elevated temperature.

Adenovirus types 3, 8, and 19 can also cause epidemic adenoviral keratoconjunctivitis. In this case, there is a feeling of a foreign body in one eye, as if sand has been poured into it. The eyelids are swollen. Keratitis manifests with photophobia, tearing, redness, pain, vision disturbances, eye discharge. Two weeks after the illness, opacities may form in the cornea, which sometimes persist for up to 2 years.

Diagnosis

The diagnosis is based on the listed clinical symptoms, medical history, and examination. If necessary, a culture is taken from the conjunctiva to identify the causative agent.

Treatment

When there is adenopharyngoconjunctival fever, it usually resolves on its own, but antibiotics are prescribed for secondary infection prevention. In the case of epidemic adenoviral keratoconjunctivitis or herpetic conjunctivitis, acyclovir ointments, drops, and antibiotic drops are prescribed for secondary infection prevention.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology