What is the treatment for conjunctivitis secondary to influenza (flu) virus?

From the Guidelines

The treatment for conjunctivitis secondary to influenza virus primarily involves supportive care while the viral infection runs its course. This approach is based on the most recent and highest quality study available, which emphasizes the importance of avoiding indiscriminate use of topical antibiotics or corticosteroids, as they can induce toxicity or worsen certain infections 1.

Supportive Care Measures

Some key measures to alleviate symptoms include:

• Cold compresses applied to the eyes for 5-10 minutes several times daily to reduce inflammation and discomfort
• Artificial tears such as carboxymethylcellulose drops (e.g., Refresh, Systane) used 4-6 times daily to provide relief from dryness and irritation
• Over-the-counter pain relievers like acetaminophen (325-650mg every 4-6 hours) or ibuprofen (400mg every 6-8 hours) to manage associated fever and discomfort

Antiviral Medications

Antiviral medications used for influenza, such as oseltamivir (Tamiflu) 75mg twice daily for 5 days, may be prescribed if the patient is within 48 hours of symptom onset, but these do not specifically target the eye symptoms 1.

Prevention of Spread

It's crucial to practice good hygiene by washing hands frequently, avoiding touching or rubbing the eyes, and using separate towels and pillowcases to prevent spreading the infection to others or from one eye to the other, as highlighted in the guidelines for conjunctivitis management 1.

Duration and Resolution

Viral conjunctivitis typically resolves within 1-2 weeks as the body clears the influenza infection. Antibiotics are not effective against viral infections and should be avoided unless there is evidence of secondary bacterial infection, a principle supported by the latest recommendations on influenza management 1.

From the Research

Treatment of Conjunctivitis Secondary to Flu Virus

The treatment for conjunctivitis secondary to influenza (flu) virus is primarily supportive, as there is no specific antiviral treatment available for this condition.

• Supportive care options include:
  • Artificial tears to relieve dryness and discomfort 2
  • Cold compresses to reduce swelling and ease symptoms 2
  • Antihistamine eye drops to alleviate itching and redness 2, 3
• It is essential to practice strict personal hygiene, including frequent handwashing, to decrease the risk of transmission 2, 4
• Topical antihistamines with mast cell-stabilizing activity may be used to treat allergic conjunctivitis, but their effectiveness in treating viral conjunctivitis is limited 2, 3
• In some cases, antiviral medications such as aciclovir, trifluridine, and valaciclovir may be used to treat herpesvirus infections, but their use in treating adenoviral conjunctivitis is limited due to toxicity concerns 5
• Cidofovir has been used successfully to treat some cases of adenoviral conjunctivitis, but its use is not widespread due to potential toxicity 5

Considerations for Treatment

• The majority of cases of viral conjunctivitis are self-limiting and do not require specific treatment 3, 6
• Treatment with empirical topical antibiotics is not recommended for viral conjunctivitis, as it may contribute to antibiotic resistance and is not effective against viral infections 3, 6
• Accurate diagnosis and specific treatment of conjunctivitis remain challenging, and laboratory testing may be necessary to identify the specific pathogen 6