Viral conjunctivitis: Difference between revisions
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==Background== | ==Background== | ||
*Most common cause of infectious conjunctivitis | *Most common cause of infectious conjunctivitis | ||
*Often preceded by URI (usually adenovirus) | *Often preceded by [[URI]] (usually [[adenovirus]]) | ||
==Clinical Features== | ==Clinical Features== | ||
*Complaint of "red eye" with mild-moderate, watery discharge | [[File:Conjunctivitis.jpg|thumb|Conjunctivitis with limbus sparing]] | ||
[[File:Conjunctivitis disease.jpg|thumb|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 | *Usually painless unless there is some degree of keratitis | ||
*Often one eye will be involved initially with other eye involved within days | *Often one eye will be involved initially with other eye involved within days | ||
*Unilateral or bilateral conjunctival injection with perilimbal sparing | *Unilateral or bilateral conjunctival injection with perilimbal sparing | ||
*Chemosis and | *Chemosis and [[subconjunctival hemorrhage]]s may be present | ||
*Preauricular lymphadenitis (adenovirus) | *Preauricular [[lymphadenitis]] (adenovirus) | ||
==Differential Diagnosis== | |||
{{Conjunctivitis DDX}} | |||
== | ==Evaluation== | ||
[[ | *[[Slit lamp]] | ||
**Follicles on inferior palpebral conjunctival | **Follicles on inferior palpebral conjunctival | ||
**Mild, punctate fluorescein staining of cornea (occasional) | **Mild, punctate fluorescein staining of cornea (occasional) | ||
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{{Clinical diagnosis of conjunctivitis}} | {{Clinical diagnosis of conjunctivitis}} | ||
==Management== | ==Management== | ||
#Artificial tears 5-6x per day | #Artificial tears 5-6x per day | ||
#Naphazoline/pheniramine 0.025%/0.3% drops 4x daily | |||
#Cold compresses | #Cold compresses | ||
#Consider topical | #Consider topical antibiotic if unable to differentiate from bacterial conjunctivitis | ||
#Frequent hand-washing (highly contagious) | #Frequent hand-washing (highly contagious) | ||
==Disposition== | ==Disposition== | ||
*Follow-up with ophtho if worsening or no improvement in 7 days | *Follow-up with ophtho if worsening or no improvement in 7 days | ||
*Viral conjunctivitis is highly contagious. Patients may return to work or school after discharge from eye(s) has resolved. Advise good hygiene practices and avoid close contact with very old, very young, or other immunocompromised individuals. | |||
==See Also== | ==See Also== | ||
*[[Conjunctivitis]] | *[[Conjunctivitis]] | ||
*[[Eye algorithms (main)]] | |||
==References== | ==References== | ||
Latest revision as of 16:09, 21 May 2024
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
- Viral conjunctivitis is highly contagious. Patients may return to work or school after discharge from eye(s) has resolved. Advise good hygiene practices and avoid close contact with very old, very young, or other immunocompromised individuals.