Viral Conjunctivitis (Pink Eye): What to Know

Viral conjunctivitis, also known as pink eye, is a highly contagious type of eye infection caused by a virus, such as an adenovirus or the herpes simplex virus (HSV). It occurs when a viral infection causes inflammation of the conjunctiva, the membrane that coats the white part of the eye.

Symptoms include:

• Eye mucus (also called eye boogers, eye gunk, or eye goop)
• Light sensitivity
• General eye irritation and redness

This article goes over the causes and symptoms of viral conjunctivitis and how this condition is diagnosed and treated.

What Are the Symptoms of Viral Conjunctivitis?

Viral conjunctivitis generally starts in one eye and then spreads to the other. Common symptoms include:

• Pink or red-tinged eyes
• Watery eye discharge, which can include a small amount of mucus
• Mild pain, grittiness, eye discomfort, a burning sensation
• Mild light sensitivity
• Crustiness around the eyelids upon waking up
• Swollen eyelids
• Typical symptoms of any viral infection such as a sore throat or a runny nose

Viral conjunctivitis often accompanies the flu and other conditions.

What Are the Causes of Viral Conjunctivitis?

Viral conjunctivitis is most commonly caused by adenoviruses, which also cause the common cold and other upper respiratory infections. Conjunctivitis caused by adenoviruses comes in two forms:

• Pharyngoconjunctival fever: Typically found in children and young adults, this type is marked by common cold symptoms like sore throat or headache.
• Epidemic keratoconjunctivitis: This type can be severe and affects the cornea. It can come in the form of watery discharge, hyperemia, chemosis, and ipsilateral lymphadenopathy. It can potentially result in long-term vision problems.

Beyond an adenovirus, your viral conjunctivitis may also be caused by:

• Rubella virus
• Rubeola virus, which causes measles
• Herpes simplex virus
• Varicella-zoster virus, which also causes chickenpox and shingles
• Epstein-Barr virus, which also causes infectious mononucleosis (mono)
• Picornaviruses

Viral conjunctivitis is extremely contagious. You can get it through direct exposure to someone with an upper respiratory tract infection. Having contact with infectious tears, eye discharge, fecal matter, or respiratory discharges can contaminate hands. You can then get viral conjunctivitis if you rub your eyes with your hands.

Viral conjunctivitis can also spread by large respiratory tract droplets. You can also contract it after getting a cold.

How is Viral Conjunctivitis Diagnosed?

Your healthcare provider will generally be able to diagnose and treat viral conjunctivitis. If your symptoms persist or worsen or you experience serious disruptions in vision, then you may be referred to an ophthalmologist or optometrist.

A healthcare provider can usually pinpoint what is causing your pink eye by examining your eye and asking about your medical history, including how your symptoms presented and if you have had close contact with someone who has conjunctivitis.

Viral conjunctivitis is likely if your symptoms are tied to a respiratory infection or common cold and if the discharge from your affected eye is watery as opposed to thick.

If your symptoms persist for two or three weeks or become more serious even with home treatments, your healthcare provider may want to perform an eye culture to determine the cause. Your healthcare provider will take a sample of the cells on the inside of your eyelids with a cotton swab and send it to a laboratory to be examined under a microscope by a pathologist, who will then be able to tell if the conjunctivitis is caused by viruses or bacteria.

How is Viral Conjunctivitis Treated?

Since viral conjunctivitis usually goes away on its own, treatment focuses mainly on symptom relief. Your healthcare provider may recommend at-home treatments to alleviate symptoms and prevent recurrence, including:

• Placing warm or cold compresses like a moist washcloth to closed eyelids three or four times a day. Warm compresses help to reduce the sticky buildup of discharge on the eyelids or crust that forms on your eyelashes, while cold compresses help to relieve itching and inflammation.
• Avoiding contact lenses and wearing glasses instead for 10 to 12 days or until the condition has resolved. Previously worn contact lenses may be a source of reinfection. Your healthcare provider may ask you to carefully disinfect or throw away those lenses and even their cases.

Your healthcare provider may prescribe steroid drops to lessen the discomfort from more serious inflammation, or, in the case of herpes virus, an anti-viral medication.

You should stay away from your workplace or school until your eyes no longer appear reddened and irritated and discharge is no longer visible. Medical professionals say it's okay for children to head back to the classroom once tearing and discharge clears. The timeline of how long this takes depends on each specific case.

How Long Does Viral Conjunctivitis Last?

Most cases of viral conjunctivitis will clear up without treatment in 7 to 14 days. Some people may continue to experience symptoms for up to 3 weeks.

Tips to Avoid Spreading Conjunctivitis

Wash your hands regularly and avoid rubbing your eyes with your fingers and then touching communal surfaces. Shaking hands is also a common way to spread the virus. The germs can move from the hand of the infected individual to the hand of the person they are touching and ultimately their eye if they rub their face.

Also, avoid sharing old or used eye makeup and eye drops with others. If you return to school or work while still infectious, make sure you aren't sharing washcloths or kitchen utensils with others. Keep in mind you can spread the virus as long as you have symptoms.

When to See a Healthcare Provider

In milder cases, viral conjunctivitis does not cause long-lasting, serious health complications. Some cases caused by viruses like herpes simplex or the varicella zoster virus, which causes the chicken pox, can potentially lead to persisting eye problems if not treated properly.

Newborns or people with weakened immune systems, such as those with cancer or an HIV infection, can experience a more severe infection.

You should contact your healthcare provider if you experience any of the following symptoms:

• Extreme redness, especially if it occurs in just one eye
• Severe eye pain
• Inability to open one eye
• Severe light sensitivity
• Disruptions to vision and inability to see clearly

If mild symptoms fail to improve over the course of a week or two, seek medical attention.

Summary

Viral conjunctivitis usually passes after about two to three weeks. The viruses that cause this condition and others can't be cured through an antibiotic or medications, but symptoms can be lessened through self-care routines at home.

If your symptoms get worse or you experience sudden, drastic changes to your vision, consult a healthcare provider.