From the Guidelines
Viral conjunctivitis treatment should focus on symptom relief and prevention of transmission, as there is no proven effective treatment for eradication of adenovirus infection. Management of viral conjunctivitis typically involves measures to reduce symptoms and prevent complications, rather than treating the virus itself. According to the most recent guidelines 1, patients with adenoviral conjunctivitis should be educated on measures to reduce the spread of the infection, such as minimizing contact with others for 10 to 14 days from the onset of symptoms.
Symptom Relief
Symptom relief can be achieved through the use of:
- Artificial tears to lubricate the eyes and wash away irritants
- Cold compresses to reduce inflammation and discomfort
- Topical antihistamines to relieve itching and discomfort
- Oral analgesics to manage pain
Prevention of Transmission
Prevention of transmission is crucial in managing viral conjunctivitis. This can be achieved by:
- Practicing good hygiene, such as washing hands frequently
- Avoiding touching or rubbing the eyes
- Using separate towels and pillowcases
- Disposing of eye makeup that may be contaminated
- Avoiding sharing of personal items
Treatment Considerations
While there is no proven effective treatment for eradication of adenovirus infection, topical corticosteroids may be used to reduce symptoms and prevent scarring in severe cases of adenoviral keratoconjunctivitis 1. However, the use of antibiotics should be avoided unless there is a bacterial superinfection, as they can induce toxicity and worsen the infection 1.
Follow-up
Close follow-up is warranted for patients with adenoviral conjunctivitis, especially those being treated with corticosteroids, to monitor for any potential complications or worsening of symptoms. If symptoms worsen, vision becomes affected, or the condition doesn't improve after a week, medical attention should be sought as these could indicate a more serious condition requiring specific treatment.
From the Research
Treatment Options for Viral Conjunctivitis
- The treatment for viral conjunctivitis is primarily supportive, focusing on relieving symptoms 2, 3, 4, 5.
- Antiviral medications such as aciclovir, trifluridine, and valaciclovir are commonly used to treat herpesvirus infections, while cidofovir has been used to treat adenoviral conjunctivitis 2.
- Artificial tears, cold compresses, and antihistamine eye drops can help alleviate symptoms of viral conjunctivitis 3, 4, 5.
- Topical dexamethasone/povidone-iodine eye drops have been shown to reduce the duration of presumed viral conjunctivitis, although they may cause more stinging than artificial tears 6.
Important Considerations
- It is essential to practice strict personal hygiene, including frequent handwashing, to decrease the risk of transmission 3, 4.
- Caution should be exercised when coadministering other pharmacological agents, such as corticosteroids, due to potential adverse effects 2.
- Ophthalmology referral is indicated for conjunctivitis in certain cases, such as in neonates or patients with severe pain, decreased vision, or immunocompromised state 3.
Diagnosis and Prognosis
- The diagnosis of viral conjunctivitis is usually made based on the typical clinical presentation, and rapid tests or PCR diagnostics can be used for confirmation 4.
- Viral conjunctivitis is often self-limiting, but it can lead to complications such as corneal or intraocular involvement, which may result in temporary or permanent impairment of vision 4.