The clinical presentation includes conjunctival hyperemia, watery discharge, swelling, sticking of the eyelids, and pruritus of the affected eye(s). Additionally, they may exhibit enlarged and tender preauricular lymph nodes, which is prevalent in patients with viral conjunctivitis [2]. Severe episodes involving the cornea will result in photophobia and foreign body sensation. Moreover, corneal opacities and pseudomembrane formation cause visual impairment.

This is highly contagious and usually follows contact with an infected person. It can also develop after a recent upper respiratory infection. There may be a simultaneous infection of both eyes or a subsequent involvement of the other eye a few days later.

Eye exam

Inspection of the eye includes findings such as redness, edematous eyelid, watery discharge, subconjunctival hemorrhages, punctuate keratopathy, and the presence of pseudomembrane. Lymphadenopathy is another common feature. Furthermore, microcysts on the cornea are indicative of viral conjunctivitis.

• Recent Viral Illness

  The clinician should obtain full details about the onset, timing, symptoms, history of recent viral illnesses, and possible exposure. Most cases do not warrant laboratory testing as testing can take time, can be costly, and inconvenient. [symptoma.com]

• Blepharitis

  Herpes simplex infection can also cause keratitis, blepharitis, and iritis. It is associated with enlarged and tender preauricular lymph node. The presentation of other viral forms of conjunctivitis depends on the specific virus. [dermnetnz.org]

  Most people who develop bacterial conjunctivitis, also have other eye conditions such as dry eyes or inflammation of the eyelids (blepharitis). [djo.harvard.edu]

  Blepharokeratoconjunctivitis is the combination of conjunctivitis with blepharitis and keratitis. [en.wikipedia.org]

  Mild itching can also be a feature of blepharitis, dry eyes and, occasionally, bacterial or viral conjunctivitis. [aafp.org]

• Excessive Tearing

  When infected with AHC, patients will experience painful, red eyes, swelling of the conjunctival tissue, and frequent mucus discharge from the eyes accompanied by excessive tearing and subconjunctival hemorrhaging. [en.wikipedia.org]

  Allergic Itching, redness, and excessive tearing, usually of both eyes. Chemical Red, watery eyes, especially after swimming in chlorinated water. Immune mediated, such as that related to a systemic disease like Kawasaki disease. [healthychildren.org]

  […] time and, in babies, a blocked tear duct. [visioneyeinstitute.com.au]

  The most common reported symptom was excessive tearing of the eye or epiphora (92.9%) followed by conjunctival hyperemia (65.8%), photophobia (54.1%), subconjunctival hemorrhage (48.1%), eye pain (47.5%), and palpebral chemosis (36.4%). [djo.harvard.edu]

  Signs and symptoms of conjunctivitis If your child has conjunctivitis, they may have: a red or pink eye (or both eyes) redness behind the eyelid swelling of the eyelids, making them appear puffy excessive tears a yellow-green discharge from the eye which [rch.org.au]

• Conjunctival Injection

  MAIN OUTCOME MEASURES: Change in six symptoms of conjunctivitis (overall discomfort, itching, foreign body sensation, tearing, redness, and lid swelling) and four signs of conjunctivitis (conjunctival injection, conjunctival chemosis, conjunctival mucus [ncbi.nlm.nih.gov]

  Physical Examination The patient had right-sided conjunctival injection, her vision was normal, and pupils were equally reactive. [consultant360.com]

  This is seen clinically as conjunctival injection with folliculitis, especially on the inferior palpepral conjunctiva. Occasionally, pinpoint subconjunctival hemorrhages may develop. [eyerounds.org]

• Burning Eyes

  Symptoms include redness in the whites of the eyes, watery eyes and a thick discharge that can seal the eyelids shut overnight. Itchy, burning eyes and blurred vision are also common. [wilx.com]

  Burning eyes – Irresistible irritation with itching and burning sensation in the eyes is typical characteristic of pinkeye. [thehealthsite.com]

  If you have pink eye, you might also: have tears have a discharge, usually yellow or green, and crusty lashes, usually worse on waking have itchy or burning eyes be sensitive to light Check your symptoms with healthdirect’s Symptom Checker to get advice [healthdirect.gov.au]

  Green or white discharge from the eye Itchy eyes Burning eyes Blurred vision More sensitive to light Swollen lymph nodes (often from a viral infection ) When to Call Your Doctor Make the call if: There’s a lot of yellow or green discharge from your eye [webmd.com]

• Unilateral Red Eye

  Viral infection of conjunctiva Commonest reason for acute unilateral red eye Usually caused by adenovirus Usually preceding or concurrent symptoms of upper respiratory infection Resolves spontaneously within week without leaving relics Sometimes easily [kellogg.umich.edu]

• Dysautonomia

  The importance of early recognition and appropriate treatment of dysautonomias is emphasised. The probable aetiopathogenesis of the neurological complications including dysautonomias is discussed. [ncbi.nlm.nih.gov]

The diagnosis is confirmed through assessment of the clinical presentation and an ocular exam. The clinician should obtain full details about the onset, timing, symptoms, history of recent viral illnesses, and possible exposure.

Most cases do not warrant laboratory testing as testing can take time, can be costly, and inconvenient [4] [5]. Severe cases where there is suspicion of orbital cellulitis warrant a polymerase chain reaction (PCR) test and possibly other immunologic studies. Additional diagnostic tools such a slit lamp test are performed in patients with photophobia.

• Lymphocytic Infiltrate

  Pinpoint the problem Diagnostic techniques for adenovirus include cytologic scrapings that reveal a mixed lymphocytic and polymorphonuclear leukocyte infiltrate and degenerated epithelial cells without inclusion bodies. [optometricmanagement.com]

The therapeutic approach includes supportive measures such as the use of cold compresses, artificial tears, topical antihistamines, and topical vasoconstrictors although the latter two are not typically beneficial. There is no indication for antivirals [6] or antibiotics [7]. Patients with visual defects or photophobia may be treated with topical steroids.

Due to the high risk of transmission, children and adults should not attend school or work until the infection has resolved. If symptoms persist beyond 7 to 10 days, patients will require an ophthalmology consult [8].

Viral conjunctivitis typically resolves within 2 to 4 weeks. Patients may have subepithelial infiltrates for a few months which may affect vision.

Most cases of conjunctivitis in all ages are caused by viruses [1], of which adenovirus accounts for up to 90% of cases [2]. Other implicated viruses include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus, poxvirus, HIV, etc.

This eye disease is prevalent worldwide. It affects families, schools, workplaces, healthcare facilities, etc. It especially occurs in the summer [3].

This contagious condition is transmitted through contact with contaminated hands, objects, or even respiratory droplets. The communicable period ranges from 10 days to 2 weeks [3].

Since this can spread rapidly in schools, workplaces, and other facilities, precautions must be implemented. Proper handwashing and other hygiene practices should be undertaken. Also, clinics should disinfect contaminated instruments and isolate patients in order to prevent transmission [9] [10].

Viral conjunctivitis is very common as it is responsible for the majority of cases of infectious conjunctivitis. The clinical picture is variable but usually features unilateral or bilateral eye involvement with redness, watery discharge, and swelling. This self-limiting disease does not warrant treatment and typically resolves in 2 to 4 weeks. All affected individuals should practice good hygiene and avoid attending school and workplaces.

What is viral conjunctivitis?

This is a condition known as "pink eye." It is very contagious and can be easily spread in schools, workplaces, and other locations through contaminated hands, objects, or air droplets.

What are the signs and symptoms?

• Eye redness
• Watery discharge
• Eye swelling
• Sticking of the eyelids particularly in the morning
• Itchiness of the eye

How is it diagnosed?

Doctors diagnose this disease by asking about the history and symptoms as well as performing an eye exam.

How is it treated?

The goal is to provide symptom relief with:

• Cold compresses
• Artificial tears

Patients must avoid going to school or work. They should also practice handwashing and good hygiene.

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3. Høvding G. Acute bacterial conjunctivitis. Acta Ophthalmologica. 2008; 86(1):5–17.
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