From the Guidelines
Viral pink eye typically resolves on its own within 7-10 days without specific antiviral treatment, and the primary approach should focus on symptom management and prevention of transmission. For symptom relief, use artificial tears (such as Refresh or Systane) 4-6 times daily to lubricate the eye and cold compresses for 5-10 minutes several times daily to reduce inflammation and discomfort 1. Avoid wearing contact lenses until symptoms completely resolve. Clean the affected eye from inner to outer corner with a clean, damp cloth several times daily to remove discharge. Viral pink eye is highly contagious, so wash hands frequently, avoid touching your eyes, and don't share towels or pillowcases. If symptoms worsen, persist beyond 10 days, or if you experience vision changes, severe pain, or light sensitivity, seek medical attention immediately.
Key Considerations
- The use of antibiotics in the management of viral pink eye should be avoided because of potential adverse treatment effects 1.
- Topical corticosteroids may be used to reduce symptoms in severe cases, but close follow-up is warranted due to the potential for prolonged viral shedding 1.
- Artificial tears, topical antihistamines, oral analgesics, or cold compresses may be used to mitigate symptoms 1.
- Debridement of the membrane can be considered for patients with membranous conjunctivitis to prevent corneal epithelial abrasions or permanent cicatricial changes 1.
Prevention of Transmission
- Patients with adenoviral conjunctivitis should be educated about measures to reduce the spread of the infection, including minimizing contact with other people for 10 to 14 days from the onset of symptoms in the last eye affected 1.
- Consider an abbreviated exam in a dedicated exam room with limited physical interaction to minimize spread within the clinic 1.
From the Research
Viral Pink Eye Overview
- Viral pink eye, also known as viral conjunctivitis, is a common disorder observed in ophthalmic emergency departments 2
- It is usually caused by herpes simplex virus (HSV) or adenovirus, and its symptoms can be variable 3
Treatment Options
- Antiviral medications such as aciclovir, trifluridine, and valaciclovir are commonly used to treat herpesvirus infections, including HSV epithelial keratitis 4, 2
- Cidofovir has been used successfully to treat some cases of adenoviral conjunctivitis, although toxicity has also been reported 2
- Trifluridine is an effective alternative to other antiviral agents, with a high success rate and minimal side effects 5
- Acyclovir, trifluridine, and brivudine are more effective than idoxuridine in treating HSV epithelial keratitis 6
Management and Prevention
- Current cases of HSV epithelial keratitis are manageable with available medications, but new advancements are required to decrease disease burden in the future 4
- The use of antiviral drugs, interferon, and corneal debridement in the treatment of HSV epithelial keratitis has been studied, with varying degrees of effectiveness 6
- Treatment for viral conjunctivitis is supportive, and antihistamines and mast cell stabilizers can alleviate the symptoms of allergic conjunctivitis 3