Viral conjunctivitis: causes, symptoms and treatment

In this article we will tell you:

• Causes of viral conjunctivitis
• Classification of viral conjunctivitis
• Adenoviral conjunctivitis
• Herpetic conjunctivitis
• Epidemic keratoconjunctivitis
• Epidemic hemorrhagic conjunctivitis
• Differences between viral conjunctivitis and bacterial and allergic
• Treatment and prevention of viral conjunctivitis

More than 45 different viruses can cause conjunctivitis, researchers say. This disease causes severe discomfort, most often affects children, but often occurs in adult patients.

In terms of prevalence, viral conjunctivitis is inferior to bacterial conjunctivitis. However, due to its high contagiousness, outbreaks of the disease are extremely difficult to control: isolated cases of viral conjunctivitis quickly develop into epidemic ones, entailing various socio-economic consequences - from the introduction of quarantines to a sharp increase in temporary disability.

From this article you will learn about what viral conjunctivitis is, how to distinguish it and react correctly if suspicious symptoms appear.

Viral conjunctivitis

is an inflammatory disease of the conjunctiva, the membrane lining the outer surface of the eyeball and the inner surface of the eyelids, caused by a virus.

What is conjunctivitis?

The name of the disease comes from the name of the area where inflammation occurs. This is the conjunctiva - a thin transparent tissue that covers the outside of the eye and the back surface of the eyelids.

In this article

• What is conjunctivitis?
• What forms of conjunctivitis occur in adults?
• What types of conjunctivitis are there in adults?
• Diagnosis of conjunctivitis in adults
• How does bacterial conjunctivitis manifest?
• Viral and adenoviral conjunctivitis in adults
• How does chlamydial conjunctivitis begin?
• Symptoms of allergic conjunctivitis

Damage to the conjunctiva can occur under the influence of various factors, such as:

• fungi
• bacteria
• viruses.

Under the influence of these pathogenic organisms, the sclera and the inner surface of the eyelids suffer. A healthy conjunctiva is completely transparent. Its texture is smooth and shiny. During the inflammatory process, it begins to rapidly turn red. Different forms of the disease can be recognized by hyperemia and swelling of the transitional folds and eyelids, mucous or purulent discharge from the eyes. Conjunctivitis is one of the most common diseases of the visual system. This is due to the high contagiousness of the disease. The infection spreads very quickly, and the first manifestations of the pathology are noticeable within the next few days after communicating with a sick person. Not all forms of conjunctivitis are transmitted by airborne droplets or contact. There is an allergic type of disease. In this case, the disease begins due to the effect of the allergen on the mucous membrane of the eye. The pathology is very common, but not dangerous. If you start therapeutic measures when the first obvious signs of conjunctivitis are detected, the disease can be easily treated. To do this, you need to know how this pathology proceeds, how it manifests itself in adults, which symptoms are the most obvious and allow the doctor to make an accurate diagnosis.

Clinical signs of epidemic keratoconjunctivitis

The onset of the disease is sudden. The inflammatory process develops alternately in both eyes. Usually, accidental touching of the eyes with hands transfers the infection from the affected eye to the healthy eye. In conjunctivitis that develops against the background of decreased tear secretion or chronic blepharitis, the disease can develop gradually.

In addition to the symptoms characteristic of all forms of conjunctivitis (pain, pain, photophobia), the following are noted:

• rapid eye fatigue;
• blurred vision;
• veil in the eyes;
• temperature increase;
• severe swelling of the eyelids;
• development of lymphadenitis on the side of the affected eye.

According to the causative factor of the disease, pathognomonic signs are noted:

1. An infection caused by an adenovirus is characterized by the presence of small hemorrhages in the conjunctiva and the formation of superficial follicles.
2. Infection with a bacterial pathogen manifests itself on the surface of the eye as a white-yellow infiltration.
3. With vernal keratoconjunctivitis, papillae are formed that look like “cobblestones”.

A doctor's examination reveals swelling and hyperemia of the conjunctiva, well-defined vascular network on the entire surface of the eye and eyelids. With a microbial etiology of the disease, accumulations of mucus or pus in the conjunctival cavity may be detected. With an allergic nature, mucus in the form of thin strips, clouding and the formation of films are found on the cornea.

What forms of conjunctivitis occur in adults?

Both adults and children are characterized by the same forms of the disease. Optometrists classify conjunctivitis based on different symptoms. They can manifest themselves in different ways, but they all have one thing in common: inflammation of the visual organs. Other symptoms of conjunctivitis “accompany” the main symptom and allow one to distinguish one form of the disease from another.

Conjunctivitis is classified based on what symptoms appear in adults. First of all, the ophthalmologist needs to determine the type of disease. Based on the symptoms, doctors distinguish between acute and chronic forms of the disease. In the first case, signs of conjunctivitis appear almost immediately after a person is infected and develop rapidly. Most often, the cause of acute conjunctivitis is infectious pathogens. It is not always possible to begin timely treatment for this form of the disease. Symptoms of conjunctivitis appear very quickly, and it is not always easy for a person who has contracted this disease to notice the preconditions that precede the pathology. Chronic conjunctivitis does not manifest itself so quickly. Its occurrence is preceded by various symptoms, on the basis of which it is not easy to make a diagnosis. It may take a long time before chronic conjunctivitis in adults manifests itself. Typically, this form of the disease occurs due to exposure of the visual organs to dust, computer radiation and other factors that can lead to irritation of the mucous membrane. The chronic form of conjunctivitis is often a consequence of other ophthalmological pathologies.

Definition and reasons

Inflammation of the connective membrane of the eye is called conjunctivitis and is considered one of the most common ophthalmological disorders. The conjunctiva is a protective barrier that protects the eyeball from the negative effects of the environment. In addition, the eye cover performs a secretory function necessary for the natural hydration of the cornea. When inflammation occurs, the transparent, smooth conjunctiva (normally) becomes cloudy and bloody. Other symptoms also appear, creating a clinical picture that often contributes to vision deterioration.

Conjunctivitis of the eyes in adults occurs due to the same reasons as in children.

For the most part, the etiology of the disease is interpreted as direct pathogens:

• bacteria (staphylococci, gonococci, etc.);
• viruses (herpes, ARVI, etc.);
• fungi;
• chlamydia;
• allergens.

However, there are also indirect causes that can cause conjunctivitis of the eyes in adults. These include:

• existing or previously suffered diseases that negatively affected the immune system;
• concomitant ophthalmological pathologies of various origins (viral, refractive);
• failure to comply with hygiene rules when caring for the eyes, for example, when using contact lenses;
• injury to the organs of vision;
• venereal diseases;
• use of low quality cosmetics.

Eye conjunctivitis in adults usually manifests itself in an acute form, when the signs of the disease are noticeably disturbing and disturbing. However, ignoring this condition or uncontrolled self-medication does not lead to recovery, but contributes to the transition of the pathology to a chronic form, requiring long-term systemic therapy.

What types of conjunctivitis are there in adults?

The next type of classification of a disease is based on the reason for its occurrence. In adults and children, the types of conjunctivitis are the same. Ophthalmologists distinguish the following types of pathology:

• Bacterial, in which the inflammatory process occurs due to various bacteria, such as: staphylococci, streptococci, gonococci, pneumococci, diphtheria and Pseudomonas aeruginosa.
• Viral, the causative agent of which is viral agents. This type of pathology often manifests itself as a consequence of a herpes virus, but can also be of an adenoviral nature;
• Chlamydia, which accompanies chlamydia of the genital organs. Newborns are also susceptible to this type of disease. In them it is much more severe than in adults.
• Allergic, in which the inflammatory process begins due to the impact of various allergens on the body’s immune system, for example: dust, wool, pollen, etc.

In some cases, eye inflammation may be characterized as dystrophic conjunctivitis in adults. The symptoms of this pathology are of a professional nature. This type of disease occurs mainly in adults. People who work in hazardous industries are susceptible to dystrophic conjunctivitis. Their visual organs suffer from exposure to harmful substances, including:

• gasoline vapors;
• paint and varnish products;
• chemical reagents.

It is quite easy to distinguish between the types of conjunctivitis by visual inspection. You can see for yourself what the eye looks like with bacterial, viral, allergic and other types of disease on the Internet. Specialized websites often post photos of people with conjunctivitis. But this does not cancel a visit to the doctor.

Diagnosis of conjunctivitis in adults

Symptoms of conjunctivitis in adults, when it comes to the acute form of the disease, are clearly visible. Usually there are no problems when making a diagnosis. The ophthalmologist examines the patient based on complaints and clinical manifestations of the disease. To determine the etiology of conjunctivitis, it is very important for the ophthalmologist to collect an anamnesis. It includes information about:

• contacts with patients;
• exposure to allergens;
• existing diseases.

In addition, the doctor should ask the patient whether he has noticed a connection between the inflammatory process and the change of season, prolonged exposure to sunlight, etc. A visual examination allows the ophthalmologist to identify hyperemia and swelling of the conjunctiva.

To determine which type of conjunctivitis a person suffers from, laboratory procedures are performed:

• biomicroscopy of the eye;
• cytological analysis of a scraping or fingerprint smear;
• bacteriological examination of a smear from the conjunctiva;
• determination of the type of antibodies to the suspected pathogen in tear fluid or blood serum;
• fluorescein instillation test;
• skin allergy tests;
• a study identifying Demodex mites.

When conjunctivitis of a specific etiology is detected, an examination by an ophthalmologist may not be enough. Depending on the symptoms, the doctor may recommend consulting an allergist, venereologist, infectious disease specialist, otolaryngologist, etc.

How does bacterial conjunctivitis manifest?

The main reason for the development of bacterial conjunctivitis is associated with immune disorders. This leads to an imbalance between pathogenic and “friendly” microflora. The disease develops very rapidly. Inflammation first begins in one eye and can easily spread to the second. Especially if a person does not follow the rules of personal hygiene. Just a few hours after contact with the patient are enough for symptoms of bacterial conjunctivitis to appear. The causes of infection are:

• diseases of the ENT organs;
• infectious skin diseases;
• disruption of the outflow of tear fluid;
• frequent colds and viral diseases;
• ingress of foreign bodies onto the surface of the conjunctiva;
• structural defects or injuries of the visual organs;
• dry eye syndrome.

In severe forms of the pathology, an adult experiences a sharp increase in body temperature. Some complain of headaches and sleep disturbances. At the first stage of bacterial conjunctivitis, discharge from the eyes is watery, but after a day it becomes purulent. The mucus released takes the form of threads. In adults, the symptoms of bacterial conjunctivitis are characterized by:

• a burning sensation, “sand” in the eyes;
• redness of the conjunctiva with profuse hemorrhages;
• increased discharge of purulent exudate from the eyes;
• the formation of crusts that prevent the opening of the eyes;
• swelling of the eyelids and mucous membranes;
• sticking of eyelids.

Treatment of bacterial conjunctivitis is often carried out using ointments: tetracycline or gentamicin. Additionally, anti-inflammatory eye drops are prescribed, as well as those based on antibiotics, for example:

• "Tobrex";
• "Ofloxacin";
• "Ciprofloxacin";
• "Lomefloxacin";
• "Framycetin".

These drugs are characterized by low absorption. They are practically not absorbed into the systemic bloodstream, affecting only pathogenic organisms that accumulate on the surface of the conjunctival membrane.

Prevention

If you or your child has conjunctivitis:

• Do not touch or rub the infected eye.
• Wash your hands frequently with soap and warm water.
• Wash out any particles that get into your eyes twice a day, using a new cotton swab or paper towel each time. Afterwards, wash your hands with soap and warm water.
• Wash your bed linens, pillowcases and towels in hot water and detergent.
• Do not wear eye makeup.
• Do not share your eye cosmetics with anyone.
• Never wear another person's contact lenses.
• Wear glasses instead of contact lenses. Throw away your used lenses and make sure to wear safety glasses for all occasions.
• Don't share things like unwashed towels or glasses.
• Wash your hands after applying eye drops or ointment to your or your child's eyes.
• Do not use eye drops that you put in an infected eye and then use on an uninfected eye.
• If your child has bacterial or viral conjunctivitis, keep him or her at home until he or she recovers completely.

And most importantly, seek help from professionals! Self-treatment of such a seemingly trivial problem as conjunctivitis can lead to serious complications!

Viral and adenoviral conjunctivitis in adults

In adults, a viral type of conjunctivitis occurs when an infection enters the upper respiratory tract. This pathology often accompanies diseases such as acute respiratory viral infections, bronchitis, and pneumonia. The inflammatory process begins due to the fact that the integrity of the mucous membrane is disrupted. This can happen as a result of:

• violations of personal hygiene rules;
• in case of hypothermia or overheating of the body;
• after improperly performed surgery.

Symptoms of viral conjunctivitis are quite common. This form of pathology is characterized by high contagiousness. This means that you can become infected through everyday contact with a sick person, for example, through household items or through airborne droplets.

The main symptoms of viral conjunctivitis are:

• increased lacrimation;
• irritation and redness of the eyes;
• swollen lymph nodes;
• increased body temperature;
• photophobia.

In some cases, small hemorrhages and small follicles form on the mucous membrane. The inflammatory process can occur in one eye, or it can affect both at the same time. The adenoviral type of conjunctivitis most often occurs in children's groups. Adults are less likely to be susceptible to this form of the disease. The first signs of adenoviral conjunctivitis are characterized by pronounced nasopharyngitis along with an increase in body temperature. First, the inflammatory process begins in one eye. After a few days, the inflammation spreads to another. This is accompanied by swelling of the eyelids and redness of the conjunctiva. The lymph nodes enlarge, and mucous discharge begins to accumulate in the corners of the eyes. To treat viral conjunctivitis, doctors prescribe artificial tears, which help normalize the hydration of the mucous membrane. Warm compresses are often used to treat the disease. Treatment of viral conjunctivitis is carried out using special drops, such as:

• "Albucid";
• "Ophthalmoferon";
• "Levomycetin";
• "Poludan";
• "Aktipol".

In addition to drops, your doctor may recommend the use of ointments. Tebrofen ointment is considered a universal remedy. It has also proven to be highly effective in treating the adenoviral form of conjunctivitis. In case of severe inflammation, ophthalmologists can prescribe eye drops based on corticosteroids, i.e. hormonal. Such drugs help balance secretion. They can only be used in short courses.

Development of the disease

The clinical picture of conjunctivitis occurs in 4 stages:

• the initial signs of the disease resemble the symptoms of ARVI (weakness, headache, fever, loss of appetite, lethargy, sleep disturbance, cough, runny nose, sore throat);
• unilateral damage to the conjunctiva of an inflammatory nature, accompanied by its redness and increased lacrimation;
• the eyelids swell, mucous discharge appears, and there is a sensation of a foreign body in the orbit;
• Photophobia develops, lymph nodes enlarge, blisters and follicles form, which cause burning, itching and pain.

It is at the last stage that there is a high probability of determining the type of conjunctivitis and making the correct diagnosis.

How does chlamydial conjunctivitis begin?

Chlamydial conjunctivitis has other names. Doctors may call this disease ocular chlamydia or ophthalmochlamydia. All this is the same disease, which occurs due to damage to the visual organs by chlamydia. It affects adults more often than children. Chlamydial conjunctivitis usually occurs against the background of chlamydia of the genitourinary tract. The disease occurs due to the entry of an infectious agent into the conjunctival sac from the genitals. This can occur due to the use of hygiene items contaminated with sexual secretions, such as towels. Often, a carrier of genitourinary chlamydia can not only become infected with chlamydial conjunctivitis themselves, but also infect their partner with it. Clinical manifestations of chlamydial conjunctivitis develop at the end of the incubation period, which can range from 5 to 14 days. First, one eye of the patient is affected, then the second. The following symptoms are characteristic of the chlamydial form of conjunctivitis:

• severe swelling;
• a burning sensation in the eyes;
• infiltration of the mucous membrane of the eyes and transitional folds;
• copious discharge of mucous or purulent exudate;
• increased lacrimation;
• photophobia.

In adults, symptoms of this pathology may appear when visiting public baths or swimming pools.

Often the disease is accompanied by lymphadenitis - damage to the lymph nodes. Or eustacheitis - an inflammatory lesion of the auditory tube. The main medications used to treat chlamydial conjunctivitis are antibiotics of different groups. It can be:

• macrolides;
• fluoroquinolones;
• tetracyclines.

Local therapy is also carried out at the same time. It involves the use of antibacterial eye drops, for example: Ofloxacin, Ciprofloxacin. Doctors often prescribe the use of ointment applications. For this purpose, tetracycline or erythromycin ointment is used.

Complications

In most cases, the prognosis with properly selected therapy is favorable. In advanced situations, inflammation can spread to the eyelids, internal structures of the eyeball and even the brain, causing severe complications with loss of vision and more serious impairments.

After long-term use of drugs for the treatment of infectious or allergic conjunctivitis, usually containing preservatives, disruption of the stability of the tear film and the development of dry eye syndrome (keratoconjunctivitis sicca) are likely. Therefore, after recovery, it is recommended to prescribe tear substitutes for a period of one month.