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Viral conjunctivitis - External and Internal Eye
Other Resources UpToDate PubMed

Viral conjunctivitis - External and Internal Eye

Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed

Synopsis

Viral conjunctivitis is more commonly known as pink eye. Although several different viruses have been known to cause conjunctivitis, by far the most common virus isolated is adenovirus. The most common symptoms of viral conjunctivitis include red eyes with excessive tearing and swelling. Vision in the early stages of adenoviral conjunctivitis is usually unchanged. With more severe viral conjunctivitis, pain and reduced vision can become more prominent. In the most severe cases, patients develop corneal scarring, chronic dry eye, and conjunctival scarring (see cicatrizing conjunctivitis). Patients with viral conjunctivitis usually have a history of sick contacts or an upper respiratory tract infection. Most commonly, symptoms begin unilaterally and then the second eye becomes involved. Patients are highly contagious as long as the eye is infected (on average 7–10 days). Depending on the strain of adenovirus, symptoms can be self-limited or patients can have postinfectious sequelae for months to years following the active infection. Epidemic keratoconjunctivitis has been reported.

Note: Although not a classical viral conjunctivitis, avian influenza A subtype H7 ("poultry flu") can lead to similar symptoms.

Codes

ICD10CM:
B30.9 – Viral conjunctivitis, unspecified

SNOMEDCT:
45261009 – Viral conjunctivitis

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Last Updated:02/16/2020
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Patient Information for Viral conjunctivitis - External and Internal Eye
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Contributors: Medical staff writer

Overview

Pink eye (conjunctivitis) is an inflammation of the tissue on the surface of the eye and/or the inside lining of the eyelids. The more common causes of pink eye include:
  • Infection (viruses, bacteria)
  • Inflammatory causes such as chemicals, fumes, dust, and debris
  • Allergies
  • Injuries
  • Oral-genital contact with someone who might be infected with a sexually transmitted disease (STD) such as chlamydia, gonorrhea, or herpes
Most people consider the term "pink eye" to imply the viral type of infection.

Who’s At Risk

Pink eye caused by viruses is very common all over the world. Nearly all people have it at one time or another. Age, sex, ethnicity, and race play no role in who becomes infected with pink eye. Following good hand-washing hygiene will decrease your chances of getting pink eye.

Signs & Symptoms

The eye is usually pink to red with an irritated appearance. There may or may not be a discharge (tears, mucous, or pus), and there may be sensitivity to bright light. There may be burning, itching, a sandy or gravely feeling, and even pain. The lids may be stuck together in the morning upon waking. Vision might be blurred by the mucous or excess tears in the eye(s). Viral pink eye typically affects both eyes.

Self-Care Guidelines

  • Wash hands frequently so as not to contaminate others or reinfect yourself.
  • Separate your towels and washcloths so that others will not be at risk.
  • If itching is the most irritating feature, apply cold compresses.
  • If swelling is bothersome, apply cold compresses.
  • If there is a lot of discharge, especially if mucous-like, use warm compresses.
  • If there is aching and/or pain, use warm compresses.
  • Wash the eyelids very gently and soak off debris; do not pick at it.
  • Never rub the eyes, as this can spread the problem.
  • Do not share contact lens paraphernalia if you or another person is affected.
Most over-the-counter medications will soothe the eye, and because most pink eye is viral and will go away on its own within 7-10 days, no other medications are usually needed.

Note: Do not rub or touch your eyes when you get a cold or upper respiratory infection, as this can spread the disease to the eyes.

When to Seek Medical Care

  • Pain is increasing.
  • Vision is worsening.
  • There is blistering and/or rash on the eyelids.
  • Swelling is increasing.
  • There is a lot of thick mucous secreting.
  • The condition is not getting better within a week.
Note: Thick, pus-laden discharge may be from a possible blinding form of pink eye and requires urgent medical care.

Treatments

Topical antibiotic, anti-inflammatory, and anti-allergy drops may all be prescribed by your doctor. If the pink eye is recurring frequently, oral antibiotics may be prescribed. If the pink eye is related to another disease elsewhere in the body (such as a respiratory disease or an STD), that disease will need treatment as well.
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Viral conjunctivitis - External and Internal Eye
A medical illustration showing key findings of Viral conjunctivitis : Eye pain, Eye irritation, Preauricular lymphadenopathy, Conjunctival injection, Eye discharge
Clinical image of Viral conjunctivitis - imageId=1917410. Click to open in gallery.  caption: 'Marked conjunctival injection, purulence at the caruncle, and crusting along the eyelid margins.'
Marked conjunctival injection, purulence at the caruncle, and crusting along the eyelid margins.
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