From the Guidelines
Supportive management of viral conjunctivitis should focus on symptom relief while the infection resolves naturally over 1-3 weeks, with an emphasis on preventing complications and improving quality of life, as recommended by the most recent guidelines 1. The primary objectives of supportive management include:
- Relieving discomfort and pain
- Preventing complications
- Preventing the spread of communicable diseases
- Educating and engaging both the patient and the referring healthcare providers in conjunctivitis management, as outlined in the conjunctivitis preferred practice pattern 1. To achieve these objectives, the following measures can be taken:
- Cold compresses applied to closed eyes for 5-10 minutes several times daily can reduce inflammation and discomfort
- Artificial tears such as carboxymethylcellulose or polyvinyl alcohol drops can be used 4-6 times daily to lubricate the eye and dilute viral particles
- For significant itching or inflammation, a short course of topical antihistamine/mast cell stabilizer drops like olopatadine 0.1% twice daily or ketotifen 0.025% twice daily may provide relief, as suggested by the treatment guidelines 1. It is essential to avoid corticosteroid eye drops unless specifically prescribed by an ophthalmologist, as they can worsen certain viral infections, and to practice strict hand hygiene, avoid touching or rubbing the eyes, use separate towels and pillowcases, and dispose of eye makeup to prevent spread, as recommended by the conjunctivitis preferred practice pattern 1. Additionally, contact lens wearers should temporarily switch to glasses until symptoms resolve completely, and most viral conjunctivitis is highly contagious, so patients should stay home from work or school for 5-7 days or until discharge resolves, as advised by the guidelines 1. If symptoms worsen, vision becomes affected, or the condition doesn't improve within 7-10 days, medical reevaluation is necessary, as indicated by the treatment guidelines 1.
From the Research
Supportive Management for Viral Conjunctivitis
- The primary approach to managing viral conjunctivitis involves supportive care, as the condition is often self-limiting 2, 3, 4.
- Supportive care options include:
- Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 2, 3.
- Topical antibiotics may be used in cases of secondary bacterial infections, but not prophylactically 3, 4.
- Local and systemic virostatic therapy may be initiated if the cornea or other ocular structures are affected by certain viruses 3.
Comparison of Treatment Options
- Studies have compared the effectiveness of topical ketorolac versus artificial tears for the treatment of viral conjunctivitis 5, 6.
- Results have shown that topical ketorolac is no better than artificial tears at relieving symptoms and signs of viral conjunctivitis, and may produce more stinging 5, 6.
- Both artificial tears and ketorolac have been found to improve symptoms and signs of conjunctivitis, with no significant difference between the two treatments 5, 6.