From the Guidelines
Viral pink eye treatment should prioritize supportive care, including artificial tears and cold compresses, while avoiding topical corticosteroids and antibiotics, as they can worsen the condition or induce toxicity, according to the most recent guidelines 1. The treatment of viral pink eye, specifically Herpes Simplex Virus (HSV) conjunctivitis, is usually self-limited and acute, but treatment may be instigated upon high suspicion or concomitant corneal involvement. Some key points to consider in the treatment of viral pink eye include:
- Using artificial tears 4-6 times daily to lubricate the eye and reduce discomfort
- Applying cold compresses for 5-10 minutes several times daily to reduce inflammation
- Managing pain with over-the-counter pain relievers like acetaminophen or ibuprofen
- Keeping the affected eye clean by gently wiping from the inner corner outward with a clean, damp cloth
- Avoiding touching the eyes, washing hands frequently, not sharing towels or pillowcases, and discarding eye makeup to prevent spreading the infection
- Staying home from work or school until symptoms improve, as viral conjunctivitis is highly contagious If symptoms worsen, vision becomes affected, or the condition doesn't improve after a week, seeking medical attention is necessary, as prescription antiviral medication, such as ganciclovir 0.15% gel or trifluridine 1% solution, or oral antivirals like acyclovir, valacyclovir, or famciclovir, may be required 1. It's essential to note that topical corticosteroids should be avoided, as they can potentiate HSV infections and worsen the condition 1. Regular follow-up visits with a healthcare provider are crucial to monitor the progression of the condition and adjust treatment as needed 1.
From the Research
Viral Pink Eye Treatment
- Viral conjunctivitis is the most common overall cause of infectious conjunctivitis and usually does not require treatment 2
- Treatment for viral conjunctivitis is supportive 2
- Antiviral medications have been introduced into clinical practice to treat viral conjunctivitis, including aciclovir, trifluridine, and valaciclovir 3
- Cidofovir has been used successfully to treat some cases of adenoviral conjunctivitis, although toxicity has also been reported 3
Topical Antiviral Therapy
- Topical antiviral therapy appeared to enable resolution of HSV epithelial keratitis that arose during oral acyclovir treatment 4
- Trifluridine and acyclovir are more effective than idoxuridine or vidarabine and similar in therapeutic effectiveness 5
- Brivudine and foscarnet do not substantially differ in effectiveness from trifluridine or acyclovir 5
- Ganciclovir is at least as effective as acyclovir 5
Treatment Outcomes
- Low certainty evidence suggests that PVP-I alone resolves signs and symptoms by seven days relative to artificial tears 6
- PVP-I or PVA-I, alone or with steroid, is associated with lower risks of SEI development than artificial tears or steroid 6
- The evidence for all estimates was of low or very low certainty due to imprecision and high risk of bias 6