Introduction
Typical of influenza states, viral conjunctivitis consists of an inflammation of the conjunctiva caused by viruses. The most common pathogens are precisely: Adenovirus, Herpes simplex, Herpes zoster and molluscum contagiosum.
Diagnosis
Viral conjunctivitis must be diagnosed and treated promptly, especially in young children most at risk of infection. Before undertaking any type of therapy, it is essential to ascertain the nature of the infection to eradicate the responsible pathogen as soon as possible.
It should not be forgotten that, in its early stages, viral conjunctivitis can easily be confused by another type of ophthalmic infection, given that the symptoms - rather vague and non-specific - are common to most eye infections.
A presumed viral conjunctivitis must be diagnosed by the ophthalmologist through the analysis of the symptoms reported by the patient (anamnesis) and the direct observation of the eye performed with adequate optical instruments. The physical examination is essential to assess the severity of the condition, as well as the degree of ocular redness, the depth of the infection and the possible co-presence of bullous lesions and / or rashes in the eyelid margin.
Symptoms and complications of viral conjunctivitis
- The typical symptoms of viral conjunctivitis to be sought during medical check-up are: hyperlacrimation, photophobia (light intolerance), eyelid edema, not particularly intense itching, redness in the eyes.
- Possible complications may include: conjunctival hemorrhage, formation of small blisters along the eyelid margin (typical lesions induced by herpetic viruses), blurred vision, corneal involvement.
The diagnostic investigation also includes the taking of a sample of conjunctival secretion: the subsequent cytological (cellular) investigation of the sample may in fact reveal the pathogen involved.
The differential diagnosis, which is very important for the purposes of therapy, must be placed with all the ocular infections that can begin - or appear later - with symptoms similar to or similar to those of the viral conjunctiva. It is therefore necessary to distinguish viral conjunctivitis from:
- Acute hemorrhagic conjunctivitis
- Allergic conjunctivitis
- Bacterial conjunctivitis
- Keratitis (corneal inflammation)
- Dry / atopic keratoconjunctivitis (inflammation of the cornea and conjunctiva)
- Adverse contact lens reactions
- Uveitis
- Eye trauma
Care
The mild (most common) forms of viral conjunctivitis, especially those supported by Adenovirus, tend to regress on their own without the need for specific medications. In this case, the most appropriate therapy is the symptomatic one, that is a type of treatment aimed exclusively at improving the symptoms, without acting in any way on the cause of origin (infection).
Cold compresses on the eyes can reduce the swelling and heaviness of the eyelids that accompany viral conjunctivitis. Even ophthalmic ointments or lubricating and humectant eye drops can improve the patient's clinical picture. Eye discomfort and inflammation can be controlled or improved through the instillation of analgesic and anti-inflammatory eye drops: in these cases, the most indicated drugs are ibuprofen and ketorolac.
The vasoconstrictor and antihistamine eye drops are not the first choice therapy since the viral conjunctivitis does not depend on an allergic reaction and the ocular itching is rather bearable.
To restrict healing time, some doctors prescribe a topical treatment with ophthalmic ointments or antiviral eye drops: acyclovir, for example, is an excellent active ingredient for the treatment of viral conjunctivitis.
- Despite what has been said, let us once again remember that antiviral drugs are not always indispensable for healing purposes because viral conjunctivitis very often regresses spontaneously.
Corticosteroid drugs, powerful anti-inflammatories, are strongly discouraged in the presence of mild viral conjunctivitis: inadequate or excessive administration of these drugs can in fact create unpleasant complications to the internal eye structures.
Treatment with topical corticosteroids, on the other hand, is fundamental in patients affected by viral conjunctivitis associated with keratitis with extension in the corneal stroma.
The relapsing forms of herpes virus keratitis can be prevented through the long-term intake of oral antiviral drugs. Similarly, the viral conjunctivitis sustained by Herpes zoster requires a systemic antiviral cure with active ingredients such as idoxuridine, vidarabine, valaciclovir or famciclovir, to be undertaken as soon as possible (starting from the onset of symptoms).
Bullous lesions and vesicles induced by a molluscum contagious conjunctival infection can be removed by cauterization, cryotherapy or surgical excision.
Prevention
Preventing viral conjunctivitis is quite simple: it is necessary to scrupulously observe the common hygienic rules to reduce the risk of viral infections in general.
As viral conjunctivitis is a highly contagious infection, affected patients should first of all avoid the promiscuous use of toiletry items (such as towels and wipes), pillows, sheets or handkerchiefs to avoid the spread of infection.
Another extremely useful trick to prevent viral conjunctivitis and eye infections in general is hand washing, which must be performed with special care and several times during the day. Clearly, washing your hands is a must before touching your eyes.
Also the use of high quality shielding sunglasses is useful to protect the eyes from dust and UV rays.
In the case of antibiotic therapy prescribed to treat a specific infection, it is advisable to take yogurt with live lactic ferments or a probiotic to strengthen the immune defenses, clearly weakened by the drugs.
A very important trick, which unfortunately tends to be underestimated, is to throw away the make-up cosmetics used in the early stages of a viral conjunctivitis. This is essential to avoid infecting the eye again after having defeated the virus.
The same applies to multidose eye drops: to minimize the risk of self-contamination (and to avoid traumatizing the eye) the spout of the eye drops must not come into contact with any eye structure.
In conclusion, it is a good idea to keep children affected by viral conjunctivitis at home from school: although symptoms can regress in 3-4 days, the infection is contagious for 7-10 days.
Prevention is synonymous with the protection of one's health and respect for others: the observation of these simple hygienic-behavioral rules is essential to limit as much as possible the spread of viral conjunctivitis.
