conjunctivitis%20-%20viral
CONJUNCTIVITIS - VIRAL
Viral conjunctivitis is the inflammation of the conjunctiva of viral etiology.
Signs and symptoms include unilateral or bilateral eye redness, foreign body sensation and follicular conjunctival reaction.
It may be caused by adenovirus, herpes simplex or molluscum contagiosum.

Follow Up

Adenovirus

  • Patients w/ severe disease who have membranous conjunctivitis should be re-evaluated w/in the week
  • Other patients should be instructed to return in 1-2 weeks if they continue to experience symptoms of red eye, decreased vision or eye pain
  • Interval history, visual acuity & slit lamp exam are done
  • Follow-up may be extended longer as the clinical picture improves (eg decrease in conjunctival reaction & discharge)
  • Patients on corticosteroid therapy must also be seen every 4-8 weeks; interval history, slit lamp exam & testing of visual acuity are done
    • Measure intraocular pressure (IOP) & pupillary dilation at baseline & periodically
  • Patients requiring repeat short-term topical corticosteroid therapy should be informed of its possible complications

Herpes Simplex Virus

  • Patients should be re-evaluated w/in 1 week
  • Subsequent follow-up may be extended longer as the clinical picture improves
  • Interval history, visual acuity & slit lamp examination are done on each visit
  • Advice of possibility of recurrence of the disease in the future, in the form of conjunctivitis, blepharitis or keratitis. This can be brought about by stress or immunocompromised state

Molluscum Contagiosum

  • Follow-up until conjunctivitis resolves

Prevention

Prevention of Spread

  • Infected individuals should be taught to wash hands frequently, use separate towels & to avoid close contact w/ others during the period of contagion (usually 7 days after onset of symptoms; some studies suggest contagion lasts 10 -14 days)
  • Disinfect exposed surfaces & equipment w/ any appropriate disinfectant, (e.g Na hypochlorite)

Referral to Ophthalmologist

  • Refer to a speciliast if w/:
    • Eye that cannot open or be kept open
    • Marked pain or photophobia
    • History of trauma or foreign body
    • Copious or progressive discharge
    • Asymmetric or nonreactive pupil
    • Ciliary flush
    • Corneal opacity
    • Visual acuity loss

Adenovirus

  • The potential sequelae & recurrent nature of the disease warrants a specialist referral; particularly if there is corneal involvement

Molluscum Contagiosum

  • For surgical management of the disease in symptomatic patients
  • Conjunctivitis may require weeks to resolve after removal of lesions
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