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Viral Conjunctivitis

Last updated Jan. 8, 2019

Approved by: Krish Tangella MD, MBA, FCAP


Conjunctivitis is inflammation of conjunctiva of the eye, which is the membrane covering the white region of the eye. This image shows a close-up of an eye with Viral Conjunctivitis.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Viral Conjunctivitides

What is Viral Conjunctivitis? (Definition/Background Information)

  • Conjunctivitis is inflammation of conjunctiva of the eye, which is the membrane covering the white region of the eye
  • In Conjunctivitis the white part of the eye turns red or pink, and hence it is also known as Pink Eye. The infection may affect either one, or both the eyes, and is accompanied by inflammation, irritation, with watery discharge from the eyes. Under normal circumstances, Conjunctivitis does not affect vision
  • The cause factors for Conjunctivitis are many; however, Viral Conjunctivitis is caused mainly by the microorganism adenovirus. It is the most common type of Conjunctivitis, of all kinds
  • In most cases the symptoms clear spontaneously within a few weeks; though supportive care is normally provided

Who gets Viral Conjunctivitis? (Age and Sex Distribution)

  • Individuals in any age group are vulnerable to Viral Conjunctivitis, but children are more at risk
  • Newborns may acquire the infection from their mothers
  • Some viruses affect children more, others affect adults, and some affect all age groups uniformly. Individuals in the age group 20-40 years are regular victims of adenovirus
  • Both male and female genders are equally affected

What are the Risk Factors for Viral Conjunctivitis? (Predisposing Factors)

The risk factors for Viral Conjunctivitis include:

  • Contact with a person affected by Pink Eye, or the use of infected (shared) items
  • This infection spreads in offices, classrooms, day care  centers, crowded spaces, and hospitals
  • Regular use of contact lens (particularly the extended wear variety)
  • Presence of certain underlying conditions such as asthma and eczema

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Viral Conjunctivitis? (Etiology)

  • Viral Conjunctivitis is frequently caused by a virus, called adenovirus. However, there are other ‘Conjunctivitis causing viruses’, such as herpes simplex, varicella zoster, picornavirus, rubella, and rubeola
  • This disorder is highly contagious and the infectious phase may last for 10-12 days, until the eye returns to normal color
  • The virus is transmitted through direct contact with items used by the infected individual; by touch (hand-to-eye route), use of shared spaces (like swimming pools), and through respiratory or nasal droplets
  • Viral Conjunctivitis may also be associated with other underlying diseases such as common cold, measles, and flu

What are the Signs and Symptoms of Viral Conjunctivitis?

Common signs & symptoms of Viral Conjunctivitis are:

  • Itching and redness of the eye(s); this may begin in one eye and slowly progress to the other
  • Formation of crusts (usually seen in the morning, on waking-up). Sticky eyelids, which are difficult to keep open
  • Eye pain and inflammation; with gritty feeling of sand-like particles inside the eye
  • Continuous discharge of watery mucus from the eyes
  • Blurred vision, light sensitivity

How is Viral Conjunctivitis Diagnosed?

Viral Conjunctivitis is diagnosed using the following tools:

  • The ophthalmologist or physician performs an eye examination and evaluates the patient’s medical history
  • Slit lamp exam (if necessary), for a detailed study of the eye
  • Biochemical studies of conjunctival scrapings; polymerase chain reaction analysis to determine the cause of the conjunctivitis. Generally such testing is not routinely used because the infection has a rapid course and majority of the cases completely recover, without any complications.
  • Differential diagnosis to eliminate other conditions; since there are several other cause factors for Conjunctivitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Viral Conjunctivitis?

Complications from Viral Conjunctivitis may arise if there are secondary conditions. These include:

  • Prolonged discomfort
  • Corneal ulcer, scar
  • Damage to the eye, loss of vision (this is rare, and happens only if corneal involvement is observed)
  • Spread of infection to other body parts
  • Possibility of a bacterial infection occurring in addition to the viral infection (termed as ‘bacterial superimposed infections’)

How is Viral Conjunctivitis Treated?

Treatment of Viral Conjunctivitis (caused by adenovirus) is mainly supportive, and based on underlying health factors. Some general management measures include:

  • Majority of the times, Viral Conjunctivitis resolves by itself spontaneously. Symptomatic treatment provides a measure of comfort and helps the affected individuals. Antiviral drugs are generally not prescribed
  • Application of warm compress can help reduce discomfort
  • Clean the eye crusts carefully using soft and wet cotton wool
  • Use of lubricating drops may soothe the eyes, and are helpful if the eyes remain dry
  • Topical corticosteroids are used if iris and cornea are involved
  • Use of topical antibiotic ointment is recommended to prevent bacterial infections
  • Avoid the use of contact lens during this period; wear eye glasses instead
  • If symptoms affect the whole body, then systemic treatment is provided

How can Viral Conjunctivitis be Prevented?

  • Viral Conjunctivitis is highly infectious. It is best to keep away from work or school, if you suffer from the condition
  • Prevent spread of the condition by maintaining hygiene, washing hands regularly, avoiding sharing of pillows, towels, make-up, and by limiting physical contact
  • Prevent aggravation of the condition by staying out of the sun, keeping away from dust and smoke. Also, avoid touching or rubbing the eyes (this may be difficult when the affected individuals are very young children)
  • Stop or restrain yourself from smoking tobacco, or drinking alcohol
  • The condition is seasonal/periodic and individuals may chronically contract Viral Conjunctivitis

What is the Prognosis of Viral Conjunctivitis? (Outcomes/Resolutions)

  • Most cases of Viral Conjunctivitis are self-limiting and have an excellent outcome with supportive management of the condition
  • If there are other underlying conditions that aggravate the infection, then certain complications may develop that would require an extended treatment course
  • Viral Conjunctivitis is a chronic infection and can recur, if conditions are conducive for its recurrence

Additional and Relevant Useful Information for Viral Conjunctivitis:

  • Many alternatives medicine therapies, natural therapy, or home remedies are available to ease the discomfort of Viral Conjunctivitis. However, such treatment methods are not a proven science and should not be substituted for a qualified healthcare provider’s medical advice

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 19, 2013
Last updated: Jan. 8, 2019