Viral Conjunctivitis: Symptoms, Diagnosis, and Treatment
Viral conjunctivitis usually goes away without treatment. It is very contagious, so it is important to wash your hands frequently and not touch your eyes if you or someone you live with has viral conjunctivitis.
Read on to learn about the symptoms, diagnosis, and treatment of viral conjunctivitis.
Viral conjunctivitis is inflammation of the conjunctiva due to a virus. Inflammation dilates, or enlarges, the blood vessels inside the conjunctiva causing redness. People describe it as “pink eye.”
Viral conjunctivitis accounts for up to 80% of conjunctivitis cases.
Viral conjunctivitis is very contagious and most commonly spreads by hand to eye contact, explains the Centers for Disease Control and Prevention (CDC).
Touching an unclean surface transfers the virus onto the hand or fingers, which then passes it directly into the eye when rubbing or touching the eyes. It can also spread from washcloths to the eyes or by droplets from coughing or sneezing that land in the eyes.
Viruses that cause conjunctivitis
Adenovirus is among the most common causes of viral conjunctivitis. Viruses that can cause conjunctivitis include:
- adenovirus, which causes colds and other upper respiratory infections
- SARS-CoV-2, which causes COVID-19
- rubeola, which causes measles
- rubella virus, which causes German measles
- herpes viruses:
A rare form of conjunctivitis called acute hemorrhagic conjunctivitis is associated with both coxsackievirus A24 and enterovirus type 70.
Symptoms of viral conjunctivitis include:
- watery eye discharge
- red, irritated eyes that may start in one eye and spread rapidly to the other
- the feeling of something in your eye
- a painful, enlarged lymph node in front of the ear
Depending on the cause, you may experience other viral illnesses and symptoms, explains the CDC. For example, viral conjunctivitis after a cold or cold-like illness is common with adenovirus conjunctivitis. Other symptoms could include:
When to see a doctor
Viral conjunctivitis is self-limiting, usually resolving on its own. Redness and discharge should improve after approximately 3–5 days, but irritation may last 2–3 weeks.
Contact an eye care professional for conjunctivitis that persists or is not improving after approximately 3 weeks, or for any of the following symptoms:
Also, contact an eye care professional if you wear contact lenses and develop symptoms of conjunctivitis.
Your eye doctor can look closely at your eyes to determine the severity of conjunctivitis. They may take a sample of discharge. They may prescribe antiviral and other medications to treat severe conjunctivitis that is not getting better on its own.
A physician or eye care professional can usually diagnose the type of conjunctivitis by examining the eye and discharge. Tests to identify the specific virus are usually not necessary unless inflammation is severe or involves other eye tissues, such as the cornea.
Your physician will ask you about recent illnesses. Often, people with viral conjunctivitis have:
- a recent exposure to someone with viral conjunctivitis
- a history of a recent upper respiratory infection such as a cold
Viral vs. bacterial conjunctivitis
Although the cause is different, symptoms of bacterial and viral conjunctivitis overlap. The presence of crustiness or a gluey feeling around the eyelids or thick greenish or yellow drainage from the eye suggests a bacterial infection.
There is a rapid test for adenovirus that your doctor’s office can perform in roughly 10 minutes. (Adenoviral infections are the most common cause of viral conjunctivitis.)
If your doctor suspects a bacterial cause or needs to identify the virus, they may take a sample of the discharge for analysis in a laboratory.
Because viral conjunctivitis is self-limiting and usually not serious, treatment aims to alleviate symptoms.
Possible treatments include:
- corticosteroid eye drops, which help decrease inflammation
- antiviral eye drops, which help against herpes viruses
Antibiotics do not treat viruses and are not helpful for viral conjunctivitis.
Tips to keep in mind:
- Apply a cool compress to your eyes several times daily to reduce symptoms.
- Use preservative-free over-the-counter (OTC) artificial tears to moisturize your eyes.
- OTC drops to decrease eye redness, such as Visine and Murine, may aggravate symptoms. Also, they are highly toxic if swallowed.
- If you wear contact lenses:
- Throw out contacts you were wearing when conjunctivitis began.
- Clean all contact cases with soap and water.
- Do not wear contact lenses until your conjunctivitis is completely gone.
- You may need to avoid work or school to prevent transmission to others.
Most cases of viral conjunctivitis go away within 3 weeks. Potential complications include:
- conjunctival scarring
- secondary bacterial infection
- keratitis, which is irritation of the cornea
- corneal ulcer, which is a hole in the cornea
- chronic infection
You can lower your chance of viral conjunctivitis in the following ways:
- Wash your hands frequently.
- Avoid touching your eyes or face with unwashed hands.
- Avoid sharing personal care items, especially washcloths, makeup, and pillowcases.
- Carefully follow your doctor’s instructions for contact lens care if you wear contact lenses.
- Keep your vaccinations up to date for COVID-19, measles, rubella, shingles, and chickenpox. An adenovirus vaccine is available for military personnel only, per the CDC.
Michaela Murphy, PA-C, reviewed the following questions.
What is the most common cause of viral conjunctivitis?
Adenovirus is the most common cause, responsible for up to 90% of viral conjunctivitis cases.
How long does viral conjunctivitis last?
Viral conjunctivitis is a common and often uncomfortable eye problem. It is one of a group of conditions commonly called pink eye. It causes eye redness and irritation and is highly contagious.
If you have viral conjunctivitis, practice hand hygiene and avoid sharing personal care items to prevent the virus from spreading to others.
Cool compresses and artificial tears eye drops may relieve symptoms. Contact your doctor if your conjunctivitis does not go away in roughly 3 weeks or causes you concern.