From the Guidelines
Viral conjunctivitis treatment should be primarily supportive, focusing on symptom management and prevention of complications, as most cases resolve on their own within 1-2 weeks. The treatment approach should prioritize reducing inflammation and discomfort, with measures such as cold compresses applied to the eyes for 5-10 minutes several times daily, and artificial tears like Refresh Tears or Systane used 4-6 times daily to lubricate the eyes and wash away irritants 1.
For symptom management, over-the-counter pain relievers like acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) may help with discomfort. It is essential to avoid wearing contact lenses until symptoms completely resolve and to discard any eye makeup used during the infection. Practicing good hygiene by washing hands frequently, using separate towels, and avoiding touching or rubbing the eyes is crucial to prevent spreading the infection to others or to the unaffected eye 1.
Antiviral medications like topical ganciclovir 0.15% gel five times daily are only indicated for specific viral causes like herpes simplex virus, as outlined in the conjunctivitis preferred practice pattern 1. Antibiotics are not effective against viral infections and should be avoided unless there is a bacterial superinfection, as their indiscriminate use can induce toxicity and potentially worsen certain infections 1.
Key considerations in managing viral conjunctivitis include:
- Avoiding the use of topical corticosteroids, which can potentiate HSV epithelial infections and should be avoided 1
- Recognizing the importance of early detection and treatment to prevent complications, especially in cases of herpes simplex virus conjunctivitis, where prompt treatment can include topical or oral antivirals 1
- Ensuring follow-up visits within 1 week of treatment to monitor progress and adjust treatment as necessary 1
From the Research
Treatment Options for Viral Conjunctivitis
- Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops 2
- Treatment with antihistamines and mast cell stabilizers alleviates the symptoms of allergic conjunctivitis, but is not typically used for viral conjunctivitis 3
- Antiviral medications, such as aciclovir, trifluridine, and valaciclovir, are commonly used to treat herpesvirus infections, while cidofovir has been used to treat some cases of adenoviral conjunctivitis 4
- In most patients, the treatment is symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically 5
Importance of Diagnosis and Hygiene
- Early diagnosis of viral conjunctivitis may help to alleviate short-term symptoms and avoid long-term consequences 6
- Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 2
- Meticulous and consistent hygiene is the most important prophylactic measure to prevent the spread of viral conjunctivitis 5
Specific Considerations
- Corticosteroid eye solution should not be used as a treatment for adenovirus conjunctivitis, as it can worsen the condition, and diagnosis of herpes simplex viral conjunctivitis is crucial for using corticosteroid eye solution as a treatment 6
- Ophthalmology referral 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