From the Guidelines
Viral conjunctivitis treatment should focus on symptom relief and preventing spread, as there is no proven effective treatment for eradication of adenovirus infection. Management of viral conjunctivitis typically involves measures to reduce symptoms and prevent transmission, rather than treating the virus itself 1.
Key Management Strategies
- Cold compresses can be applied to closed eyes for 5-10 minutes several times daily to reduce inflammation and discomfort.
- Artificial tears (preservative-free preferred) can be used 4-6 times daily to lubricate the eye and dilute viral particles.
- For severe itching or irritation, over-the-counter antihistamine eye drops like ketotifen (Zaditor, Alaway) can provide relief.
- Keeping eyes clean by gently wiping from inner to outer corner with clean, damp cotton or cloth, avoiding touching or rubbing eyes, practicing frequent handwashing, and not sharing towels, pillowcases, or eye makeup can help prevent transmission.
- Contact lens wearers should temporarily switch to glasses until symptoms resolve.
- Topical corticosteroids may be used to reduce symptoms and potentially reduce scarring in severe cases, but close follow-up is warranted due to the potential for prolonged viral shedding 1.
Important Considerations
- Antibiotics are ineffective against viral infections and should not be used unless there is a bacterial superinfection 1.
- Antiviral medications like ganciclovir ophthalmic gel are rarely needed except for specific viral causes like herpes.
- If symptoms worsen, vision becomes affected, or the condition does not improve after a week, medical evaluation is necessary as some viral eye infections can cause corneal damage if left untreated.
From the Research
Viral Conjunctivitis Treatment
- The treatment for viral conjunctivitis is primarily supportive, with options including artificial tears, cold compresses, and antihistamine eye drops 2.
- Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission 2, 3, 4.
- Topical antihistamines with mast cell-stabilizing activity are not typically used for viral conjunctivitis, but rather for allergic conjunctivitis 2, 5.
- Antiviral medications, such as aciclovir, trifluridine, and valaciclovir, may be used to treat herpesvirus infections, while cidofovir has been used to treat some cases of adenoviral conjunctivitis 6.
- For other viral causes of conjunctivitis, no effective remedy is currently available, and treatment focuses on the relief of symptoms 6, 5.
Diagnosis and Prevention
- A comprehensive history and physical examination can guide diagnosis, as there is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis 2.
- Rapid tests or PCR diagnostics are available for confirmation of viral conjunctivitis, but diagnosis is usually made without further tests on the basis of the typical clinical presentation 4.
- Meticulous and consistent hygiene is the most important prophylactic measure to prevent the spread of viral conjunctivitis 3, 4.
- Early diagnosis of viral conjunctivitis may help to alleviate short-term symptoms and avoid long-term consequences 3.