Conjunctiva
Viral Conjunctivitis
Also known as: pink eye, watery red eye, adenoviral conjunctivitis, epidemic keratoconjunctivitis, EKC, viral pink eye, acute follicular conjunctivitis
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
The most common cause of infectious conjunctivitis. Usually adenoviral, self-limiting, and highly contagious. Managed with supportive care and strict hygiene to limit spread.
Recognition
Symptoms: what patients report
- Watery or muco-watery discharge — not thick or purulent.
- Gritty, burning, or foreign-body irritation rather than significant pain.
- Redness, usually starting in one eye and spreading to the fellow eye within 3–5 days.
- Pain, strong photophobia, and reduced visual acuity are usually absent unless keratitis or another red flag is present.
- Recent upper respiratory tract infection or exposure to an infected person.
Signs: what the examination shows
- Follicular reaction on lower tarsal conjunctiva (soft, pale mounds).
- Diffuse pink-red bulbar and palpebral conjunctival injection.
- Watery discharge.
- Tender preauricular lymph node — a key distinguishing feature from bacterial conjunctivitis.
- Subconjunctival haemorrhages in epidemic keratoconjunctivitis (EKC) or enteroviral conjunctivitis.
- Pseudomembranes on tarsal conjunctiva in severe EKC.
- Subepithelial infiltrates (SEIs) on the cornea — may develop 1–2 weeks into EKC and cause blurred vision.
What OptoGuide™ covers for viral conjunctivitis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Conjunctivitis (viral, non-herpetic) — College of Optometrists CMG
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Case 14-2023: A 31-Year-Old Man with Redness of the Right Eye. Barshak MB, Dugdale CM, Pineda R. The New England Journal of Medicine. 2023;388(19):1800-1810.
- Eye Infections. Durand ML, Barshak MB, Sobrin L. The New England Journal of Medicine. 2023;389(25):2363-2375.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.