Viral Conjunctivitis
Viral infection of conjunctiva Commonest reason for acute unilateral red eye Usually caused by adenovirus Usually preceding or concurrent symptoms of upper respiratory infection Resolves spontaneously within week without leaving relics Sometimes easily spread by contact, so hygiene critical Contagion low once discharge resolves No effective anti-microbial treatment
Allergic conjunctivitis, bacterial conjunctivitis, immunogenic conjunctivitis, chlamydial conjunctivitis, stye, dacryocystitis, BUT... Allergic conjunctivitis usually bilateral and itchy and produces no preauricular node enlargement or tendernessBacterial conjunctivitis has more engorgement of conjunctival vessels and thicker dischargeImmunogenic conjunctivitis more chronic, produces minimal vessel engorgement, no discharge, preauricular node enlargement, tendernessChlamydial conjunctivitis chronic and affects mostly lower conjunctivaStye produces mostly lid swelling and focal tendernessDacryocystitis produces mound-like swelling and tenderness in region of lacrimal sac
Do not prescribe anti-infectives as they do not work; applying them only leads to spread of infection via hand contact Urge strict hygiene, including frequent hand-washing, no touching eyes or sharing towels, and avoidance of communal activities (work, school, daycare) as long as discharge is present Refer if diagnosis in question, symptoms appear to worsen, or you suspect concurrent keratitis
In most cases, manifestations resolve spontaneously within 3-5 days Therefore, if symptoms do not resolve within 3-5 days, or if vision loss develops, question diagnosis and refer urgently to ophthalmologist
