From the Guidelines
Conjunctivitis is often associated with upper respiratory infections (URIs).
Relationship between Conjunctivitis and URI
The relationship between conjunctivitis and URI is supported by the fact that many types of conjunctivitis are caused by viruses and bacteria that can also cause URIs [ 1 ].
- Viral conjunctivitis is often associated with concurrent upper respiratory infections, and can be spread by exposure to infected individuals, especially in school settings [ 1 ].
- Bacterial conjunctivitis can also be associated with pharyngitis, otitis media, and other URIs [ 1 ].
Key Factors
Some key factors that contribute to the relationship between conjunctivitis and URI include:
- Exposure to infected individuals: This can occur through direct or indirect contact with secretions from an affected person's eyes, nose, or throat [ 1 ].
- Concurrent infections: Conjunctivitis can occur concurrently with other infections, such as otitis media, sinusitis, or pharyngitis [ 1 ].
- Systemic diseases: Systemic diseases, such as atopy or acute infections, can also cause conjunctival inflammation [ 1 ].
From the Research
Relationship between Conjunctivitis and Upper Respiratory Infection (URI)
- Conjunctivitis can be a symptom of an upper respiratory infection (URI), as seen in studies where patients with URI also presented with conjunctivitis 2, 3, 4, 5, 6
- The ocular surface can be a potential site of virus replication and a portal of entry for establishment of a respiratory infection, as demonstrated in a ferret model of ocular inoculation with influenza virus 2
- Viral conjunctivitis is often accompanied by symptoms of the upper and lower respiratory tract, fever, chills, arthralgia, or skin lesions 5
- The spectrum of pathogens that can cause viral conjunctivitis includes DNA viruses such as Adeno-, Herpes simplex, and Molluscum contagiosum, as well as RNA viruses, including pandemic pathogens such as SARS-CoV-2 5
Mechanisms of Virus Spread
- Replication-independent deposition of virus inoculum from ocular to respiratory tissue was limited to the nares and upper trachea, unlike traditional intranasal inoculation which results in virus deposition in both upper and lower respiratory tract tissues 2
- Virus transmissibility to naïve contacts by respiratory droplets was reduced following ocular inoculation, despite high titers of replicating transmissible seasonal viruses in the upper respiratory tract of ferrets inoculated by the ocular route 2
Clinical Presentation and Diagnosis
- The diagnosis of viral conjunctivitis is usually made without further tests on the basis of the typical clinical presentation, but rapid tests or PCR diagnostics are also available for confirmation 5
- Symptoms of viral conjunctivitis can range from a minor conjunctivitis resulting from an upper respiratory tract infection to a serious, debilitating epidemic keratoconjunctivitis 6
- Careful history taking can help in identifying a viral cause, and local care and interventions to minimize transmission are the cornerstones of management 6
Prophylaxis and Treatment
- The most important prophylactic measure is meticulous and consistent hygiene 5
- Treatment is usually symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically 5
- If the cornea or other ocular structures are affected by certain viruses, local as well as systemic virostatic therapy is initiated 5