Recently, when taking your child swimming, be sure to watch out for this contagious disease!

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In the hot summer, parents like to take their children to swimming pools to enjoy the cool. At this time, we need to be particularly vigilant about an summer prevalent pathogen attacking the eyes, and that is –adenoviruses.

Adenoviruses are prone to spread in enclosed or crowded places, such as summer camps or public swimming pools. Therefore,adenoviral conjunctivitis is also prone to occur after swimming. Let’s delve into what viral conjunctivitis is all about.

What is Viral Conjunctivitis?

Viral conjunctivitis is usually caused by adenoviruses, involving multiple serotypes, among which Group D can cause epidemic keratoconjunctivitis (EKC),which is a special case and will be discussed separately later.

Left: Healthy eyes; Right: Viral conjunctivitis

Not just eye symptoms,

it is often a harbinger of systemic infection

When we talk about conjunctivitis, we often think that only the eyes will be uncomfortable, but viral conjunctivitis may be a harbinger of systemic viral infections, which may later present with –lymphadenopathy, fever, pharyngitis, and upper respiratory tract infections.

And viral conjunctivitis usually manifests as –

The other eye usually starts to show symptoms within 24-48 hours, but it is also possible not to be infected.

At the same time, viral conjunctivitis is highly contagious, not only the other eye of the same person may be infected,people around may also have contact infection.

A Special Form of Viral Conjunctivitis:

Epidemic Keratoconjunctivitis

Epidemic keratoconjunctivitis (EKC)is a more special form of viral conjunctivitis, particularly explosive, patients usuallyfirst present with conjunctivitis, and then keratitis(inflammation of the cornea)a few days later. The disease is usually caused by adenovirus types 8, 19, and 37.

However,the clinical manifestations of different patients may vary, the same virus strain may cause epidemic keratoconjunctivitis in one patient and ordinary viral conjunctivitis in another, which may be related to immunity.

In addition to the typical symptoms of viral conjunctivitis, patients also have foreign body sensation, multiple corneal infiltrates(usually manifested as pain, blurred vision, etc.).

Corneal Infiltrates

Can Viral Conjunctivitis Heal on Its Own?

Viral conjunctivitis is a self-limiting condition that can resolve and dissipate on its own, and the whole process is a bit like the common cold.

For example, symptoms often worsen in the first 3-5 days, but then very slowly improve over the next 1-2 weeks,with a total course of about 2-3 weeks.

Just like cold patients who continue to have morning cough and nasal congestion or abnormal discharge for 2 weeks after the onset of symptoms, patients with viral conjunctivitis may also have morning eye crusting for 2 weeks after the onset of symptoms, but red eyes, irritation, and tearing during the day will greatly improve within 2 weeks.

Viral conjunctivitis may also be accompanied by herpes simplex keratitis, acute varicella-zoster(chickenpox)or ocular herpes zoster.

If acute conjunctivitis is not effectively controlled, a pseudomembrane may appear a few days after onset. The so-called pseudomembrane is a coagulum on the surface of the conjunctival epithelium.Pseudomembranes, once identified, need to be removed promptly.

When to See a Doctor?

You should visit an ophthalmologist urgently when the following situations occur:

How to Treat?

There are antigen or nucleic acid tests for adenoviral conjunctivitis, which can quickly identify the pathogen.

Although there is currently no specific antiviral medication for local or systemic use in viral conjunctivitis, and systemic antibiotics and antiviral treatments are also ineffective, medication can be used to relieve symptoms when necessary:

During the course of viral conjunctivitis, ocular irritation and abnormal discharge usually worsen for 3-5 days before improving, and the entire course may last 2-3 weeks. During this period, any topical medication(antibiotics or antihistamines/decongestants)itself may be irritating and toxic, potentially causing red eyes and abnormal discharge, therefore do not use or change medications lightly. If you cannot judge and handle the situation on your own during the course, you can visit an ophthalmologist for professional medical advice.

When treating acute conjunctivitis,avoid using ocular steroids(corticosteroids, including tobramycin dexamethasone, prednisolone acetate)^[1]. If used improperly,complications from corticosteroids can affect vision, such as corneal scarring, melting, and perforation. Long-term use of ocular corticosteroids can also lead to cataracts and glaucoma^[2].

However, it is important to note that in cases of epidemic keratoconjunctivitis with keratitis changes, ocular steroids may need to be used appropriately after medical assessment.

How to Protect Yourself Daily?

Viral conjunctivitis is highly contagious and should avoid transmission caused by direct contact with discharge, contaminants(such as cosmetics, contact lenses). Infected individuals should not share handkerchiefs, tissues, towels, cosmetics, bed linen, or tableware with others.

The safest way to prevent transmission to others is to stay at home until there is no abnormal discharge.

The timing of the loss of contagiousness of viral conjunctivitis varies, and the resumption of daily activities should be determined based on specific circumstances.

Finally, remind all parents and children to pay attention to eye hygiene, do not touch clearly contaminated water sources, avoid rubbing eyes, stay away from adenovirus infections, and maintain eye health!