Viral conjunctivitis

1. VIRAL CONJUNCTIVITIS
BY,
ROUF ABDUR
GROUP NO 7
8TH SEMESTER

2. Conjunctivitis
• Inflammation of conjunctiva.
• Conjunctival hyperaemia.
• Associated with discharge – watery , mucoid , mucopurulent or
purulent.
• Also known by names : Pink Eye OR Madras Eye.

3. Viral conjunctivitis
•Common in all age groups.
•Most common cause :
Adenovirus
•Most problematic cause:
Herpes simplex virus.
•Mostly , epithelium is
affected (both of cornea &
conjunctiva) so, typical viral
lesion is
Keratocunjunctivitis.

4. ETIOLOGY
• Adenovirus conjunctivitis
• Herpes simplex
keratoconjunctivitis
• Pox virus conjunctivitis
• Myxovirus conjunctivitis
• Paramyxovirus conjunctivitis
• Arbovirus conjunctivitis

5. Clinical presentations
•Acute Serous Conjunctivitis
•Acute Haemorrhagic Conjunctivitis
•Acute Follicular Conjunctivitis

6. Acute serous conjunctivitis
Etiology :
• Mild grade viral infection with no
follicular response.
Clinical Feature :
• Minimal degree of congestion
• Watery discharge
• Boggy swelling of conjunctival mucosa
Treatment:
• self limiting
• Broad spectrum antibiotics for 7days to
prevent secondary infection.

7. Acute haemorhagic conjunctivitis
• Acute inflammation of conjunctiva
characterized by :
a) Multiple Conjunctival Haemorrhages
b) Conjunctival Hyperaemia
c) Mild Follicular Hyperplasia.
• Etiology :
• Picornavirus (enterovirus type 70)
• Contagious.
• Clinical Picture :
• Incubation period : short (1-2 days).
• Symptoms : Pain , Redness , Watering
,Mild Photophobia , Transient Blurring
of Vision & Lid Swelling.

8. • Signs :
- Conjunctival Congestion
- Chemosis – swelling of conjunctiva
- Multiple Haemorrhages in Bulbar Conjunctiva
- Mild Follicular Hyperplasia
- Lid Oedema
- Preauricular Lymphadenopathy
• Corneal involvement in form of Fine Epithelial
Keratitis .
• Treatment :
• No specific curative treatment known.
• Prophylactic measures important.
• Broad spectrum antibiotic eye drops used for 5-7 days
to prevent secondary bacterial infection.

9. Acute follicular conjunctivitis
• Acute catarrhal conjunctivitis.
• Associated with marked follicular
hyperplasia especially of lower fornix &
lower palpebral conjunctiva.
Etiological Types :
Adult Inclusion Conjunctivitis
Epidemic Keratoconjunctivitis
Pharyngoconjunctival Fever
Newcastle Conjunctivitis
Acute Herpetic Conjunctivitis

10. • Epidemic Keratoconjunctivitis :
• Etiology :
- Most commonly associated serotypes include adenovirus 8, 19, and 37.
- Less frequently, serotypes 2-5, 7, 9, 10, 11, 14, 16, 21, and 29.
- Epidemics tend to occur in closed institutions (eg, schools, hospitals,
camps, nursing homes, workplaces).
- Direct contact with eye secretions is the major mode of transmission.
Clinical Picture :
•Incubation Period : about 8 days & virus is shed off in 2-3
weeks.
•Clinical Stages :
First phase – Acute Serous Conjunctivitis
Second phase – Typical Acute Follicular Conjunctivitis
Third phase – Acute Pseudomembranous Conjunctivitis
(severe cases)
Corneal involvement in form of Superficial Punctate
Keratitis
Preauricular Lymphadenopathy.

11. Clinical Picture :
•Incubation Period : about 8 days & virus is shed off
in 2-3 weeks.
•Clinical Stages :
First phase – Acute Serous Conjunctivitis
Second phase – Typical Acute Follicular
Conjunctivitis
Third phase – Acute Pseudomembranous
Conjunctivitis (severe cases)
Corneal involvement in form of Superficial
Punctate Keratitis
Preauricular Lymphadenopathy.

12. • Newcastle Conjunctivitis :
• Etiology :
- Rare
- Caused by Newcastle Virus.
- Contact with diseased Owls & Chickens .
- Mainly affects poultry workers.
• Clinically :
- Similar to Pharyngoconjunctival Fever.
• Diagnosis
 Through clinical features
 Culture , Smear & Stain
 Virus Isolation
• Medication
 Topical artificial tears - 4-8 times per day, for
1-3 weeks
 Topical vasoconstrictor/antihistamine - 4
times per day, for severe itching
 Topical steroids - For pseudomembranes and
subepithelial infiltrates
 Topical antibiotic - To prevent bacterial
superinfection
 Topical antiviral agents - For HSV infection
 Oral acyclovir - For VZV infection
Prevention
• Hygiene
• Avoid close contact with patients
• Patients should avoid rubbing eyes
• Vaccination against Adenovirus is
effective.