From the Guidelines
The primary treatment for viral conjunctivitis is supportive care, as the condition is usually self-limiting and resolves on its own within 1-2 weeks. This approach is based on the most recent and highest quality study available, which emphasizes the importance of supportive care in managing viral conjunctivitis 1.
Key Components of Supportive Care
- Applying cold compresses to the affected eye(s) for 5-10 minutes, 3-4 times daily, to reduce inflammation and discomfort
- Using artificial tears (preservative-free if possible) every 2-3 hours to lubricate the eye and wash away irritants
- Over-the-counter pain relievers like acetaminophen or ibuprofen to manage any associated discomfort
- Preventing spread by avoiding touching or rubbing the eyes, washing hands frequently, and not sharing towels or washcloths
Specific Considerations
- In cases of herpes simplex virus conjunctivitis, treatment may involve topical antiviral medications such as ganciclovir 0.15% gel or trifluridine 1% solution, as well as oral antivirals like acyclovir, valacyclovir, or famciclovir 1
- Topical corticosteroids should be avoided in viral conjunctivitis, as they can potentiate HSV epithelial infections and worsen the condition 1
- Patients should be counseled on the importance of hand washing and preventing the spread of the disease, especially in cases of contagious conjunctivitis 1
When to Seek Medical Attention
- If symptoms persist beyond two weeks
- In severe cases
- If there is suspicion of a bacterial superinfection
- If the patient has a weakened immune system or is at risk for complications
By following this supportive care approach and considering specific treatment options for certain types of viral conjunctivitis, patients can effectively manage their symptoms and prevent complications, ultimately improving their quality of life and reducing morbidity and mortality associated with the condition.
From the Research
Treatment Options for Viral Conjunctivitis
- Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops 2
- Topical antihistamines with mast cell-stabilizing activity are not typically used for viral conjunctivitis, but are the treatment of choice for allergic conjunctivitis 2
- For specific types of viral conjunctivitis, such as those caused by herpesvirus, antiviral medications like aciclovir, trifluridine, and valaciclovir may be used 3
- Cidofovir has been used to treat adenoviral conjunctivitis, but toxicity has been reported 3
Considerations for Treatment
- Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission of viral conjunctivitis 2
- Referral to an ophthalmologist 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 2
- Topical corticosteroids may be useful in treating ocular inflammation, but their use is generally recommended in severe cases of conjunctivitis due to associated risks 4
- Combination therapies of corticosteroids with anti-infectives may be effective and well-tolerated for short-term treatment of acute conjunctivitis, but further evidence is needed to support their use 4