Viral conjunctivitis

Generality

Viral conjunctivitis is an inflammatory process of the conjunctiva caused by viruses.

Similar to other forms of conjunctival inflammation; the viral variant also begins with common symptoms; like abundant watery eyes; light intolerance (photophobia); palpebral swelling and red eyes (conjunctival hyperemia). The symptoms described above require a diagnostic assessment given that; being highly non-specific; it is not always easy to recognize the root cause. Not by chance; Viral conjunctivitis is often confused with an ophthalmic infection sustained by bacteria.

In addition to the causal factor; what distinguishes viral conjunctivitis from the bacterial variant is therapy: while eye infections sustained by bacteria always require antibiotic treatment; viral conjunctivitis tends to resolve spontaneously; without necessarily resorting to an antiviral treatment.

Please note

Being an extremely contagious condition; viral conjunctivitis requires the necessary care in limiting the spread of infection; as well as strict compliance with hygiene standards to speed up healing.

Infectivity and transmission

Viral conjunctivitis is a highly contagious infection: in principle; the virus can be transmitted from person to person for a variable period of 10 to 12 days after the onset of symptoms.

Strictly speaking; affected patients should avoid both direct contact with others; both sharing towels; pillows and toiletries in general. Moreover; to speed up spontaneous healing and minimize the risk of relapse; it is recommended to resist the temptation to scratch your eyes with your hands (especially if dirty).

The transmission of the virus can occur through the accidental inoculation of viral particles directly from the hands of the victim; more often; by contact with saliva micro-drops coming from the upper respiratory tract of an infected patient. Rarely; viral conjunctivitis can be transmitted indirectly from subject to subject in contaminated water (common pools).

Causes

As we have seen; the cause of viral conjunctivitis must be sought in a virus-supported insult: more often; in these cases; conjunctival inflammation is related to an upper respiratory infection; including the common cold and sore throat.

The pathogens most involved are:

• Adenovirus; viral agents implicated in numerous diseases of the respiratory tract and in other infectious processes such as gastroenteritis and hemorrhagic cystitis
• Herpes simplex; the same virus responsible for herpetic and genital lesions
• Shingles; the main causal agent of shingles and post-herpetic neuralgia
• Molluscum contagiosum; also involved in chronic follicular conjunctivitis
• Picornavirus: responsible for acute hemorrhagic conjunctivitis which; despite being clinically similar to the adenoviral one; it has a haemorrhagic character and is extremely serious and contagious.

Types of viral conjunctivitis

Although they are still viral infections; the conjunctivitis supported by viruses are not all the same; they differ essentially according to the symptoms accused by the patient and to the easily observable signs. To simplify the analysis; the table shows the distinctive features of the most common forms of viral conjunctivitis.

Adenovirus viral conjunctivitis
Generality Infection; which often involves both eyes; it is highly infectious: Incubation time: 3-29 days Contagiousness: about 14 days	Risk factors Exposure to an infected individual Upper respiratory tract infections	Signs keratitis; or inflammation of the cornea (possible) Eyelid ecchymosis Eyelid edema Subconjunctival bleeding (possible) follicles Fotofobia Preauricular lymphadenopathy (enlarged lymph nodes)	Suggestive symptoms Burning and ocular itching iperlacrimazione Possible pharyngo-conjunctival fever (typical of adults and children with respiratory tract infections) Rare (but possible) corneal involvement
Herpes simplex viral conjunctivitis (HSV)
Generality The infection supported by HSV-1 mainly infects adults and middle-aged subjects; HSV-2 primarily affects children born to infected mothers during vaginal delivery	Risk factors Direct exposure to an infected individual Previous ocular infection or cold sores Physical and / or psychological stress Environmental stress (frequent exposure to smog; wind; cold; UV light, etc.)	Signs Keratitis follicles Fotofobia Aqueous secretion Enlarged preauricular lymph nodes Swollen eyelids Eyelid papules (small reddened small bumps) Herpetic vesicles along the eyelid margin (possible)	Characteristic symptoms heartburn Unilateral pain Possible degeneration of the palpebral papules in painful ulcers Sensation of sand in the eye Blurred vision
Herpes zoster viral conjunctivitis
Generality It is caused by the reactivation of varicella-zoster virus; after healing of primary infection (varicella)	Risk factors Direct contact with a person infected with the virus Inhalation of infected saliva micro-drops Old age Immunodeficiency Physical trauma (eg ophthalmic surgery)	Signs Eye redness Involvement of the eyelid skin (obvious blistering lesions) follicles Intolerance to light Abundant watering Serous / muco-purulent secretions	Symptoms Temperature General malaise Nausea He retched
Contagious mollusc viral conjunctivitis
Generality Despite being a rather rare event; the contagious mollusc may also involve the conjunctival mucous membranes. It is a typical conjunctival infection of immunosuppressed patients (affected by the HIV virus)	Risk factors HIV virus Alteration of immune defenses Genetic predisposition	Signs Formation of small nodules along the eyelid margin Conjunctival follicles Uni / bilateral infection Irritative eyelid lesions Serious multiple eyelid irritative lesions (typical of AIDS patients)	Symptoms heartburn Ache Blurring of vision itch

In general; viral conjunctivitis is distinguished from the bacterial and allergic variant for lacrimation; always abundant and rather watery; and for the marked intolerance to light . The viral origin of conjunctivitis is almost certain in the presence of typical flu symptoms: as we have seen; indeed; this condition is closely linked to cold and flu.