conjunctivitis%20-%20viral
CONJUNCTIVITIS - VIRAL
Treatment Guideline Chart
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.

Conjunctivitis%20-%20viral Management

Prevention of Spread

Adenovirus

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

Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV)

  • Infected individuals should be taught to wash hands frequently, use separate towels and to avoid close contact with others during the period of contagion
  • Disinfect exposed surfaces and equipment with Na hypochlorite or any other appropriate disinfectant

Referral to Ophthalmologist

  • Refer to a specialist if with the following conditions:
    • 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

Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV)

  • The potential sequelae and 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

Follow Up

Adenovirus

  • Patients with severe disease who have membranous conjunctivitis should be re-evaluated within 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 and slit lamp exam are done
  • Follow-up may be extended longer as the clinical picture improves (eg decrease in conjunctival reaction and discharge)
  • Patients on corticosteroid therapy must also be seen every 4-8 weeks; interval history, slit lamp exam and testing of visual acuity are done
    • Measure IOP and pupillary dilation at baseline and periodically
  • Patients requiring repeat short-term topical corticosteroid therapy should be informed of its possible complications

Herpes Simplex Virus (HSV)

  • Patients should be re-evaluated within 1 week
  • Subsequent follow-up may be extended longer as the clinical picture improves
  • Interval history, visual acuity and 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
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