Viral Conjunctivitis: What It Is, Symptoms, and Types

A red eye, stinging, and tearing — a familiar picture. Behind it may be viral conjunctivitis: inflammation of the mucous membrane of the eye that often comes along with a cold. I break down how to recognize it and when it's time to see a doctor.

What viral conjunctivitis is

Conjunctivitis is inflammation of the outer layer of the eye and the inner surface of the eyelid. It causes swelling, itching, burning, discharge, and redness. The causes vary: bacterial or viral infection, allergy, irritants, contact lens solutions, drops, and ointments.

The viral variant is the one where the cause is a virus. Such an infection passes easily from person to person. In most people everything settles within a couple of weeks even without special treatment, and antibiotics do not act against viruses.

Which viruses cause the disease: adenoviral and herpetic conjunctivitis

Viral conjunctivitis is transmitted by airborne droplets and causes outbreaks mainly in children's groups — kindergartens and schools. Among the causative agents are adenoviruses, coronaviruses, and other viruses, and adenoviral, enteroviral, and herpetic conjunctivitis are distinguished separately.

Adenoviral conjunctivitis, also known as pharyngoconjunctival fever, is the most common scenario. Involvement of the eyes is preceded or accompanied by involvement of the upper respiratory tract, fever rises, and preauricular lymph nodes enlarge (more often in children). The discharge is scanty and non-purulent; in children, follicles or membranes often appear.

Herpetic conjunctivitis is associated with herpes infection and can also occur against the background of a cold.

Symptoms of viral conjunctivitis

Usually one eye becomes red, then the infection moves to the other eye. Stinging appears in the corner of the eye, the vessels dilate, the conjunctiva looks bright red, and photophobia is possible.

• redness of the conjunctiva;
• stinging and tearing;
• photophobia;
• moderate spasm of the eyelids;
• scanty non-purulent discharge.

In the bacterial variant the emphasis is different: the discharge is viscous, gray or yellowish, the eyelids stick together in the morning, and symptoms appear about the third day after infection. With allergic conjunctivitis the eyes itch and tear intensely, but such a person is not contagious.

My quick self-test — it does not diagnose anything, but it helps describe the picture to the doctor. Look in the mirror in daylight: where is the redness stronger — in the corner or across the whole mucosa. Recall whether the eyelashes stuck together in the morning. Check whether there was a runny nose, sore throat, or fever the day before. Assess whether you feel like squinting from the light.

Why a sore throat and conjunctivitis appear at the same time

Viral conjunctivitis is most often associated with an upper respiratory tract infection — adenoviral or herpetic. They can appear with an ordinary cold and sore throat.

Symptoms manifest differently — this depends on age, immunity, and the degree of infection.

Features in children and in adults

In adults, 85% of conjunctivitis cases are caused by adenoviruses and only 15% by bacteria. In children, the bacterial and adenoviral variants occur with equal frequency. Follicles, membranes, and enlarged preauricular lymph nodes are also more common in children.

Viral conjunctivitis in a child often comes from kindergarten or school in a whole wave.

How it is diagnosed and when to see a doctor

The doctor examines the eyes and eyelids, clarifies how it all started, whether there was a runny nose, fever, contact with sick people, and checks whether there are membranes, follicles, or enlarged lymph nodes. The doctor assesses the picture by examination and questioning.

Make an appointment with a doctor: if a child has red sticky eyes (urgently — if the child is under 30 days old); if you wear contact lenses and spots on the eyelids appeared along with the symptoms; if the symptoms have not resolved within 7 days.

A doctor is urgently needed if there is pain in the eyes, photophobia has appeared, vision has changed — wavy lines, flashes — the eyes are very red (one or both), and also if there are red sticky eyes in a child under 30 days old. These may be signs of a more serious eye problem.

Viral conjunctivitis by itself is not a reason to call an ambulance. 103 or 112 — for a life-threatening condition (for example, serious injury, stroke, heart attack).

This material is for reference: it helps you get your bearings and ask the doctor the right questions, but it does not replace a consultation with a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer