Viral conjunctivitis - Clinicals, Diagnosis, and Management

Opthalmology

Clinicals - History

Fact Explanation
Ocular itch. Due to the acute inflammation of the conjunctiva . Ocular itch.
Due to the acute inflammation of the conjunctiva .
Tearing. Tears are produced by stimulating the terminations of the 5th cranial nerve,
such as those branches ending in an inflamed conjunctiva .
Tearing.
Tears are produced by stimulating the terminations of the 5th cranial nerve,
such as those branches ending in an inflamed conjunctiva .
Red eye. Due to dilatation of the conjunctival blood vessels as a result of the inflammatory response . Red eye.
Due to dilatation of the conjunctival blood vessels as a result of the inflammatory response .
Purulent discharge. It occurs in herpes zoster ophthalmicus as a result of vesicular eruptions of purulent material from the conjuncitvae . Purulent discharge.
It occurs in herpes zoster ophthalmicus as a result of vesicular eruptions of purulent material from the conjuncitvae .
History of recent exposure to individuals who have conjunctivitis or upper respiratory tract infection. Viral conjunctivitis is highly contagious . History of recent exposure to individuals who have conjunctivitis or upper respiratory tract infection.
Viral conjunctivitis is highly contagious .

Clinicals - Examination

Fact Explanation
Unilateral or bilateral conjunctival hyperemia. Due to dilatation of the conjunctival blood vessels as a result of the inflammatory response . Unilateral or bilateral conjunctival hyperemia.
Due to dilatation of the conjunctival blood vessels as a result of the inflammatory response .
Preauricular lymphadenopathy. The conjunctivae drain to the preauricular lymph nodes . Preauricular lymphadenopathy.
The conjunctivae drain to the preauricular lymph nodes .
Corneal dendrites on slit lamp examination. Occasionally, the cornea may show a immune reaction . This occurs commonly in conjunctivitis caused by herpes simplex virus. Corneal dendrites on slit lamp examination.
Occasionally, the cornea may show a immune reaction . This occurs commonly in conjunctivitis caused by herpes simplex virus.
Purulent discharge. It occurs in herpes zoster ophthalmicus as a result of vesicular eruptions of purulent material from the conjuncitvae . Purulent discharge.
It occurs in herpes zoster ophthalmicus as a result of vesicular eruptions of purulent material from the conjuncitvae .

Investigations - Diagnosis

Fact Explanation
It is mainly a clinical diagnosis. Acute infectious conjunctivitis is mostly a self-limiting disease, and symptomatic management is usually adequate whatever the cause may be . It is mainly a clinical diagnosis.
Acute infectious conjunctivitis is mostly a self-limiting disease, and symptomatic management is usually adequate whatever the cause may be .
Slit lamp examination to identify corneal dendrites. This occurs in conjunctivitis caused by herpes simplex virus and should be differentiated from other causes of conjunctivitis since the management differs . Slit lamp examination to identify corneal dendrites.
This occurs in conjunctivitis caused by herpes simplex virus and should be differentiated from other causes of conjunctivitis since the management differs .

Management - Supportive

Fact Explanation
Maintenance of good hygiene by the patient: Hand washing; avoiding the sharing personal items; taking leave from work (when it involves close contact with other individuals) until eye discharge ceases; avoidance of using public swimming pools. Viral conjunctivitis is highly contagious . Maintenance of good hygiene by the patient: Hand washing; avoiding the sharing personal items; taking leave from work (when it involves close contact with other individuals) until eye discharge ceases; avoidance of using public swimming pools.
Viral conjunctivitis is highly contagious .
Use of cold compresses. It improves patient comfort by causing vasoconstriction . Use of cold compresses.
It improves patient comfort by causing vasoconstriction .
Artificial tears. It improves patient comfort by acting as a lubricant . Artificial tears.
It improves patient comfort by acting as a lubricant .

Management - Specific

Fact Explanation
Topical steroids (Prednisolone ophthalmic solution). 1-2 drops of 1% solution twice a day. Its anti-inflammatory properties reduce occular edema . This should be used with caution because steroid eye drops may worsen ocular herpetic disease. Topical steroids (Prednisolone ophthalmic solution). 1-2 drops of 1% solution twice a day.
Its anti-inflammatory properties reduce occular edema . This should be used with caution because steroid eye drops may worsen ocular herpetic disease.
Topical antibiotics. At times the diagnosis is difficult to discern from bacterial conjunctivitis . Topical antibiotics.
At times the diagnosis is difficult to discern from bacterial conjunctivitis .
Topical antivirals. Trifluridine 1% drops, five times per day, or vidarabine 3% ointment, five times per day for 10-14 days. It is used when there is a diagnosis of herpes simplex ocular infection since corneal involvement is common and it is a major cause of corneal blindness . Topical antivirals. Trifluridine 1% drops, five times per day, or vidarabine 3% ointment, five times per day for 10-14 days.
It is used when there is a diagnosis of herpes simplex ocular infection since corneal involvement is common and it is a major cause of corneal blindness .

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