Viral Conjunctivitis: Causes, Symptoms, Diagnosis, and Treatments

Viral conjunctivitis, a common inflammation of the conjunctiva, is often caused by viruses such as Adenovirus, Herpes simplex, Herpes zoster, and Molluscum contagiosum. This blog post provides an overview of the diagnostic strategies, treatment options, and preventive measures for this ophthalmic infection.

Causes of Viral Conjunctivitis

The most common cause of viral conjunctivitis is the adenovirus, a DNA virus that is also responsible for a range of other respiratory and ocular infections. Adenoviruses can survive on surfaces for long periods, making them particularly effective at spreading from person to person. Other viruses that can cause conjunctivitis include:

• Herpes simplex virus (HSV)
• Varicella-zoster virus (VZV)
• Enteroviruses
• Picornaviruses

Transmission

Viral conjunctivitis is primarily spread through direct or indirect contact with the ocular secretions of an infected individual. Common modes of transmission include:

• Person-to-Person Contact: Direct contact with an infected person, such as through touching or shaking hands, followed by touching one's own eyes.
• Contaminated Surfaces: Touching doorknobs, computer keyboards, or towels that have been contaminated with the virus, and then touching the eyes.
• Respiratory Droplets: Spread through droplets from coughs or sneezes that land on the eye or are rubbed in after touching the face.
• Swimming Pools: Improperly chlorinated water can be a medium for viruses, particularly those causing epidemic keratoconjunctivitis.

Symptoms and Complications

Viral conjunctivitis typically presents with a variety of symptoms that affect ocular comfort and vision. The primary symptoms include:

• Hyper-tearing: Excessive tearing is a common response as the eye attempts to clear the viral agents.
• Photophobia: This is a heightened sensitivity to light, which can cause discomfort in bright environments.
• Eyelid Edema: Swelling of the eyelids can occur, contributing to a puffy appearance and discomfort.
• Mild Itching: Patients often experience a persistent itchiness that can aggravate if it leads to rubbing of the eyes.
• Eye Redness: The most common signs of viral conjunctivitis is the distinct redness of the eye.

While viral conjunctivitis is usually a self-limiting condition, it can lead to several complications if not managed properly:

• Conjunctival Hemorrhage: The irritation and swelling can cause small blood vessels in the conjunctiva to break, leading to minor bleeding.
• Formation of Small Vesicles: Tiny blisters may form along the eyelid margins, which can cause further irritation and risk of infection.
• Blurred Vision: The inflammation and discharge may temporarily blur vision, complicating daily activities.
• Corneal Involvement: In more severe cases, the virus may affect the cornea, potentially leading to keratitis (the inflammation of the cornea).

Diagnosis

Diagnosing viral conjunctivitis promptly is very important, especially in young children who are more susceptible to infections. Before initiating any treatment, it is essential to confirm the nature of the infection to eliminate the responsible pathogen swiftly.

In its early stages, viral conjunctivitis can be mistaken for other types of ocular infections due to non-specific and vague symptoms common to most eye infections. Therefore, it is important for ophthalmologists to diagnose presumed viral conjunctivitis through a detailed analysis of the patient's symptoms and direct observation of the eye using appropriate optical instruments.

A sample of conjunctival secretion is often taken for cytological investigation to identify the involved pathogen. The differential diagnosis must distinguish viral conjunctivitis from other ocular infections that can present with similar symptoms.

Treatments

Mild forms of viral conjunctivitis, especially those caused by Adenovirus, often regress on their own without the need for specific medications. In such cases, symptomatic therapy is most appropriate, aimed at improving symptoms without directly addressing the original cause.

Cold compresses on the eyes can reduce swelling and eyelid heaviness, while ophthalmic ointments or lubricating eye drops can improve the patient's clinical picture. Analgesic and anti-inflammatory eye drops can control or improve eye discomfort and inflammation.

To reduce healing times, some doctors prescribe a topical treatment with antiviral ophthalmic ointments or eye drops. However, antiviral drugs are not always essential for healing as viral conjunctivitis often regresses spontaneously.

Corticosteroid drugs, powerful anti-inflammatory drugs, are generally discouraged for mild viral conjunctivitis due to the potential for complications. However, topical corticosteroid therapy is critical in patients with viral conjunctivitis associated with keratitis.

Prevention Strategies

Preventing viral conjunctivitis involves observing hygiene rules to reduce the risk of viral infections. Since viral conjunctivitis is highly contagious, patients should avoid sharing toiletries to prevent the spread of the infection.

Hand washing is also very important to prevent viral conjunctivitis, especially before touching your eyes. Shielding sunglasses can also protect your eyes from dust and UV rays.

During antibiotic therapy, taking yogurt with live lactic ferments or a probiotic can strengthen the immune defenses. It is also recommended to discard any make-up cosmetics used in the early stages of viral conjunctivitis to avoid re-infecting the eye.

In conclusion, observing these simple hygiene and behavioral rules is essential to limit the spread of viral conjunctivitis. Prevention is synonymous with protecting one's health and respecting others.