Viral conjunctivitis

Question 1

Features

Answer 1

• Very contagious (examine with gloves)
• Usually due to adenovirus
• Tends to occur in epidemics (pink eye)
• 2–3 wk course
• Starts in one eye, spreads to other
• Scant watery discharge
• May be tiny pale lymphoid follicles
• Preauricular lymph node
• Can perform viral culture and serology to predict epidemics.

Question 2

Treatment

Answer 2

Limit cross-infection by appropriate rules of hygiene and patient education; infectious until redness and weeping resolve (usually 10–12 d)

Treatment is symptomatic (e.g. cool compress and topical lubricants-artificial tear preparations) or salt-water bathing

Do not pad; avoid bright lights

Watch for secondary bacterial infection

Avoid corticosteroids—prolong the infection

Question 3

Primary herpes simplex infection

Answer 3

• A follicular conjunctivitis
• 50% have lid or corneal ulcers (diagnostic)
• Dendritic ulceration with fluorescein (in some)

Treatment of herpes simplex keratitis

• Attend to eye hygiene
• Aciclovir 3% oint, 5 times/d for 14 d or for at least 3 d after healing
• Atropine 1% 1 drop, 12 hrly, for the duration of Rx will prevent reflex spasm of the pupil (specialist supervision)
• Debridement by a consultant