From the Guidelines
Management of viral conjunctivitis in a daycare setting requires the child to remain home from daycare for 10 to 14 days from the onset of symptoms in the last eye affected, as viral conjunctivitis is highly contagious. For symptom relief, use cold compresses applied to closed eyelids for 5-10 minutes several times daily. Artificial tears such as Refresh or Systane can be used 4-6 times daily to relieve irritation. Clean eye discharge with clean, warm water and separate washcloths for each eye, wiping from inner to outer corner. Avoid sharing towels, pillowcases, and eye drops to prevent transmission. Antiviral medications are generally not indicated for common viral conjunctivitis. Parents and caregivers should practice strict hand hygiene before and after touching the child's eyes or face. If symptoms worsen, persist beyond 7-10 days, or if the child develops eye pain, light sensitivity, or vision changes, medical reevaluation is necessary. Viral conjunctivitis is typically self-limiting, caused most commonly by adenovirus, and resolves without specific antiviral treatment as the body's immune system clears the infection 1.
Some key considerations for managing viral conjunctivitis in a daycare setting include:
- Educating the patient and family about proper hygiene to prevent the spread of infection 1
- Avoiding close contact with others during the period of contagion, which is usually 10 to 14 days from onset 1
- Using separate towels and pillows to prevent transmission 1
- Practicing strict hand hygiene before and after touching the child's eyes or face 1
- Avoiding sharing eye drops, towels, and pillowcases to prevent transmission 1
It is essential to note that there is no proven effective treatment for eradication of adenovirus infection; however, artificial tears, topical antihistamines, topical steroids, oral analgesics, or cold compresses may be used to mitigate symptoms 1. The use of antibiotics in the management of this viral infection should be avoided because of potential adverse treatment effects 1. Topical corticosteroids are helpful to reduce symptoms and may reduce scarring in severe cases of adenoviral keratoconjunctivitis with marked chemosis or eyelid swelling, epithelial sloughing, or membranous conjunctivitis 1.
From the Research
Management of Viral Conjunctivitis in Daycare Settings
- The management of viral conjunctivitis in daycare settings is crucial to prevent the spread of the infection among children 2.
- A study found that significant drivers for deciding to treat infectious conjunctivitis with antibiotics included patient's clinical presentation, family expectations, antibiotic stewardship concerns, etiological diagnostic uncertainty, and school/daycare policies 2.
- However, the same study noted that no providers were aware of pediatric treatment guidelines or standardized recommendations for return to school or daycare, highlighting the need for clear guidelines in this area 2.
Treatment Options for Viral Conjunctivitis
- Several studies have compared the efficacy of different treatment options for viral conjunctivitis, including topical ketorolac, artificial tears, and dexamethasone/povidone-iodine eye drops 3, 4, 5.
- The results of these studies suggest that artificial tears are a effective treatment option for viral conjunctivitis, and may be as effective as other treatments in relieving symptoms and signs of the infection 3, 5.
- However, some studies have found that certain treatments, such as dexamethasone/povidone-iodine eye drops, may reduce the duration of conjunctivitis, although they may also cause more stinging than artificial tears 4.
Importance of Guidelines and Education
- The study by 2 highlights the importance of creating guidelines for the evaluation and management of infectious conjunctivitis in children, as well as updating guidelines for school/daycare exclusion.
- Education of families and healthcare providers is also crucial in reducing unnecessary antibiotic prescribing and promoting evidence-based exclusion practices 2.
- Additionally, the use of artificial tears and other treatment options should be guided by clear recommendations and guidelines to ensure effective management of viral conjunctivitis in daycare settings.