What is the protocol for hospital isolation of a patient with viral conjunctivitis?

From the Guidelines

Isolation is not typically required for patients with viral conjunctivitis in hospital settings, as standard precautions and contact precautions can effectively prevent the spread of infection. Patients can remain in regular hospital rooms with standard precautions, including good hand hygiene and avoiding sharing personal items 1. Healthcare workers should practice contact precautions when examining the patient, including wearing gloves and washing hands thoroughly before and after patient contact. Equipment used for eye examinations should be properly disinfected between patients. Viral conjunctivitis is highly contagious but primarily spreads through direct contact with eye secretions or contaminated objects. The infection usually resolves on its own within 7-14 days without specific antiviral treatment. Symptomatic care includes artificial tears for comfort, cold compresses to reduce inflammation, and avoiding contact lens wear until symptoms resolve. Patients should be advised to avoid touching their eyes and to wash hands frequently to prevent spreading the infection to others or to their unaffected eye. If bacterial superinfection is suspected, topical antibiotics may be prescribed, but these are not effective against the viral cause itself 1.

Some key considerations for managing viral conjunctivitis include:

• Educating patients on proper hygiene to prevent the spread of infection 1
• Using standard precautions and contact precautions when examining patients 1
• Properly disinfecting equipment used for eye examinations 1
• Avoiding the use of topical antibiotics or corticosteroids unless necessary 1
• Providing symptomatic care, such as artificial tears and cold compresses, to reduce discomfort and inflammation 1

It is also important to note that some types of conjunctivitis, such as gonococcal conjunctivitis, may require more aggressive treatment and hospitalization 1. However, for viral conjunctivitis, isolation is not typically necessary, and standard precautions can effectively prevent the spread of infection. The goal of treatment is to eliminate or reduce signs and symptoms of conjunctivitis, restore or maintain normal visual function, and prevent the spread of infectious conjunctivitis 1.

From the Research

Isolation in Hospital for Viral Conjunctivitis

• Viral conjunctivitis is a highly contagious condition, with adenoviruses accounting for 65% to 90% of cases 2.
• The condition can lead to large outbreaks, especially in settings like military installations and medical facilities 2.
• Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 3.
• Isolation in a hospital setting may be necessary to prevent the spread of the infection, especially in cases of epidemic keratoconjunctivitis (EKC) 2.
• However, there is no clear consensus on the efficacy of isolation in hospital for viral conjunctivitis, and more research is needed to determine the best course of treatment 2, 4, 5.

Treatment and Management

• Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops 3.
• Topical antihistamines with mast cell-stabilizing activity are the treatment of choice for allergic conjunctivitis 3.
• Corticosteroids may be used as an anti-inflammatory agent in infective conjunctivitis, but their use has been met with concerns about prolonged infection 6.
• Antiviral medications, such as aciclovir and trifluridine, may be effective in treating viral conjunctivitis, but more research is needed to determine their efficacy 4.

Prevention and Control

• Strict implementation of hand washing laws and sanitization of surfaces is crucial to control the spread of viral conjunctivitis 5.
• Early diagnosis and treatment of viral conjunctivitis can help alleviate short-term symptoms and avoid long-term consequences 5.
• Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state 3.