Clinical features:

Ø  Common symptoms include itching, foreign body sensation, watering of eyes.

Ø  It can also present as pharyngoconjunctival fever and acute haemorrhagic conjunctivitis.

Ø  Frequently a history of recent upper respiratory tract infection or contact with a patient. It often starts in one eye and involves the fellow eye a few days later.

Ø  On examination, inferior palpebral conjunctival follicles and pinpoint subconjunctival haemorrhages are observed.

Ø  The common organism responsible is Adenovirus.

Ø  Conjunctival cultures/swabs are not needed unless the discharge is excessive or the condition becomes chronic.

Non- pharmacological treatment:

l  Self-limiting condition that typically gets worse for the first 4 to 7 days after onset and may not resolve for 2 to 3 weeks or longer if there is corneal involvement.

l  It is highly contagious, usually for 10 to 12 days from onset as long as the eyes are red (when not on steroids).

l  Use dark goggles and avoid close contact with other persons for two weeks.

l  Restrict work and school for patients with significant exposure to others.

l  Frequent handwashing and cool compresses several times per day. Pharmacological treatment:

1.       Preservative-free artificial tears (carboxy methyl cellulose 0.5% eye drops) four to eight times per day for 1 to 3 weeks. Use single-use vials to limit tip contamination and spread of disease.

2.       Antihistamine (e.g., epinastine 0.05% BD) if itching is severe.

3.       Anti-inflammatory drops like ketorolac 0.5% may also be used if needed.

4.       If a membrane / pseudomembrane are present, use a steroid in form of drops with or without ointment (e.g. loteprednol 0.5% QID, flurometholone 0.1% ointment QID or dexamethasone 0.3% ointment QID). Steroid treatment is maintained depending upon the response and then slowly tapered.Routine / unsupervised use of topical antibiotics or steroids should be discouraged.

Patient education:

u  Patients should avoid touching their eyes, shaking hands, sharing handkerchiefs, towels with family members.

u  Patient’s drops or ointment must not be used by other members of the family.