Does Viral Conjunctivitis Cause a Burning Sensation?
Yes, viral conjunctivitis typically causes a burning sensation in the eyes, along with other symptoms like redness, watery discharge, and irritation. 1
Clinical Presentation of Viral Conjunctivitis
Viral conjunctivitis presents with several characteristic symptoms:
- Burning or irritation sensation in the eyes
- Abrupt onset of symptoms
- Initially unilateral, often becoming sequentially bilateral
- Watery discharge (not purulent)
- Bulbar conjunctival injection (redness)
- Follicular reaction of inferior tarsal conjunctiva
- Chemosis (conjunctival swelling)
- Eyelid swelling and erythema 2, 1
Distinctive Signs
Viral conjunctivitis can be differentiated from other types by several distinctive features:
- Preauricular lymphadenopathy (swollen lymph nodes in front of the ear)
- Petechial and subconjunctival hemorrhages
- Watery rather than purulent discharge
- Possible membrane/pseudomembrane formation
- Eyelid ecchymosis (bruising) 2, 1
Specific Types of Viral Conjunctivitis
Different viruses can cause slightly different symptom patterns:
Adenovirus (most common - 80% of viral cases)
- Burning sensation
- Watery discharge
- Redness
- Preauricular lymphadenopathy
- May develop corneal involvement 3, 4
Herpes Simplex Virus (HSV)
- Usually unilateral
- Burning sensation
- Watery discharge
- Mild follicular reaction
- May have preauricular lymphadenopathy
- Can lead to more serious complications if untreated 2, 1
Varicella Zoster Virus (VZV)
- Unilateral or bilateral
- Burning discomfort
- Watery discharge
- May have vesicular dermatomal rash on eyelids
- Distinctive pseudodendritic (non-excavated) epithelial keratitis 2, 1
Management Considerations
The burning sensation and other symptoms of viral conjunctivitis can be managed with:
- Supportive care including artificial tears to lubricate and soothe the burning sensation
- Cold compresses to reduce inflammation and burning
- Strict personal hygiene to prevent transmission
- Avoiding contact lens wear during infection
- Most cases are self-limiting within 1-2 weeks 1, 5
Important Cautions
- Misdiagnosis of viral conjunctivitis (particularly HSV or VZV) as bacterial can lead to inappropriate treatment and complications
- Topical corticosteroids should be avoided without ophthalmologic consultation as they can worsen certain viral infections, particularly herpes simplex virus 1
- If burning sensation is accompanied by severe pain, decreased vision, or symptoms persist beyond 7-10 days, ophthalmology referral is indicated 1, 5