Viral conjunctivitis is acquired by direct contact with fingers, towels, washcloths, contaminated ophthalmic instruments, contaminated swimming pools, other infected eye, infected person, or other viral infection elsewhere in the body. The most common viruses are adenovirus, herpes simplex virus, enterovirus. Except for herpes, most viral infections are self-limited.Topical corticosteroids are not recommended for the treatment of HSV, as they may exacerbate the condition 

1. Viral
Conjunctivitis
Vinod Kumar Mugada
Associate Professor
Department of Pharmacy Practice
Vignan Institute of Pharmaceutical Technology

2. Organisms
Most common
1. Adenovirus- most common in
adults and children
2. Herpes Simplex Virus
3. Enterovirus
Least common
1. HIV
2. Picornavirus
3. Poxvirus

3. Transmission
Viral conjunctivitis is acquired by direct
contact with fingers, towels, washcloths,
contaminated ophthalmic instruments,
contaminated swimming pools, other infected
eye, infected person, or other viral infection
elsewhere in the body

4. History & Physical- findings
ENT
 Pharyngitis- pharyngeal
inflammation
 Lymphadenopathy- Preauricular
lymphadenopathy is a common
presentation
General
Fever – in adenoviral
pharyngoconjunctivitis

5. History & Physical- findings
Ophthalmic
 Subconjunctival hemorrhage
 Corneal erosion
 Iris finding
 Pruritis
 Photophobia
Ophthalmic
 Eye discharge
 Red eye
 Conjunctival finding
 Edema of eyelid

6. Treatment
• Except for herpes, most viral
infections are self-limited.
• Topical corticosteroids are not
recommended for the treatment of
HSV, as they may exacerbate the
condition
• Herpes zoster ophthalmicus must
be treated with oral antivirals
• In severe cases of adenoviral
keratoconjunctivitis, topical
steroids may be beneficial
• In addition, artificial tears, topical
antihistamines, or cold compresses
may provide symptomatic relief

7. Treatment
Antivirals
Topical trifluridine solution is
available for the treatment of
conjunctival herpes simplex virus
(HSV).
Systemic antiviral options include
acyclovir, valacyclovir, and
famciclovir
Patients who are
immunocompromised should receive
parenteral therapy
Antivirals
Systemic therapy is indicated for severe
eye disease or when systemic
manifestations are present
For immunocompetent patients with
herpes zoster infection and an ophthalmic
rash, oral antiviral therapy is appropriate.

8. Treatment
Conjunctival HSV
• Trifluridine
• Acyclovir
Suspected and known herpes
zoster
1. Valacyclovir Hcl
2. Famciclovir
3. Acyclovir- in immunocompromised
patients also