How to treat red eye due to adenovirus conjunctivits
Adenoviral conjunctivitis, often referred to as viral pink eye, is a highly contagious eye infection caused by adenoviruses. It affects the conjunctiva, the clear, thin membrane that lines the white part of the eye and the inside of the eyelids. This form of conjunctivitis is responsible for the majority of viral eye infections seen worldwide, especially in communal environments such as schools, workplaces, and clinics.
The onset of adenoviral conjunctivitis is usually sudden. Patients typically experience irritation or a gritty sensation in one eye, followed by redness and watery discharge.
- Incubation period: 5 to 12 days after exposure
- Symptoms typically start in one eye and spread to the other within 2 to 3 days
The primary cause is the adenovirus, a group of viruses that can also affect the respiratory tract, urinary tract, and gastrointestinal system. The subtypes most commonly linked to conjunctivitis include:
- Adenovirus serotypes 3, 4, 7, 8, 19, and 37
- Spread through direct contact, contaminated hands, towels, swimming pools, and respiratory droplets.
Once the adenovirus enters the eye:
- It attaches to epithelial cells of the conjunctiva.
- It invades and replicates within these cells.
- The body’s immune response is triggered, resulting in inflammation and the classic symptoms of red, itchy, and watery eyes.
- Redness of the eye
- Watery discharge (not thick or purulent)
- Foreign body sensation
- Itching or burning
- Swollen eyelids
- Enlarged, tender preauricular lymph nodes
- Photophobia (light sensitivity)
- Blurred vision, especially if corneal involvement occurs
- Follicular conjunctival reaction
- Pseudomembranes in severe cases
There is currently no approved antiviral for treating adenoviral conjunctivitis. Management focuses on symptom relief and preventing transmission.
Supportive Treatment
- Artificial tears for lubrication
- Cold compressions to reduce swelling and irritation
- Topical antihistamines or vasoconstrictors for itchiness and redness
- Topical steroids (only in severe cases and under supervision) to reduce inflammation.
Topical steroids are generally avoided in adenoviral conjunctivitis because they can suppress the local immune response, which may lead to prolonged viral shedding and delay the natural resolution of the infection. While steroids can temporarily reduce inflammation and discomfort, their use can also increase the risk of secondary bacterial infections and viral keratitis, especially in cases with corneal involvement.
Topical NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) can be used instead of steroids to help relieve discomfort, redness, and inflammation without suppressing the immune response or increasing the risk of viral persistence and secondary infections.However, NSAIDs also have limitations i.e. they mainly provide symptomatic relief and do not shorten the course of the viral infection. They should be used cautiously if there’s any corneal involvement, as they can delay epithelial healing in some cases. It is important to always get your eyes checked to observe the progression of the disease.
Because adenoviral conjunctivitis is highly contagious, prevention is key:
- Avoid touching or rubbing eyes
- Wash hands frequently
- Use separate towels and pillows
- Avoid wearing contact lenses during infection
- Disinfect commonly touched surfaces
- Do not share eye drops, cosmetics, or face cloths
If not properly managed, complications may include:
- Subepithelial corneal infiltrates (can cause blurred vision)
- Membranous or pseudomembranous conjunctivitis
- Secondary bacterial infection
- Keratitis
- Chronic conjunctivitis
- Rarely, scarring of the cornea or conjunctiva
Founder of EyesMatterMost- an optometry student who loves talking about eyes. I tend to cover topics related to optometry, ophthalmology, eye health, eyecare, eye cosmetics and everything in between. This website is a medium to educate my readers everything related to eyes.