Pharyngoconjunctival Fever Symptoms and Treatment

Pharyngoconjunctival fever is a condition characterized by a fever, sore throat, and follicular conjunctivitis. Pharyngoconjunctival fever, also known as PCF, is often seen in school children because they are in close quarters.

Blue eye with redness in the white of the eye
Adrian Samson / Getty Images

Who's at Risk?

A condition caused by a virus, pharyngoconjunctival fever is highly contagious, especially during the first few days. After 10 or 15 days the communicability is almost zero. The incubation period of the virus is 5-12 days and people suffering from it can have a fever for up to ten days. Children between the ages of 5 and 18 are most susceptible to the condition. Kids attending summer camps often pass it around, and it is especially rampant during the spring and fall seasons in schools. It is often spread by kids swimming in public swimming pools.

General Symptoms

People who have PCF often complain of fatigue and upset stomach. Some may also have a pharyngitis. A pharyngitis is an inflammation of the throat that appears reddened and is covered with bumps called follicles. They also may develop swollen lymph nodes in the neck region. The lymph nodes an often be detected through touch and are often tender and sore.

Eye Symptoms

The eyes tend to be very sensitive to PCF. Eye complaints and symptoms usually appear within 48 hours of onset. The following symptoms are very commonly seen:

  • Itching
  • Burning
  • Gritty sensation
  • Tearing
  • Discharge
  • Mild light sensitivity
  • Swollen eyelids
  • Redness

People who develop PCF develop a general redness of the eye that begins on the red lower part of the inside of the eyelids and extends onto the globe of the eye. This gives the conjunctiva (the clear tissue that lines the inside of the eyelids and that lies on top of the white part of the eye) a gelatinous, swollen appearance. Also, small clear bumps called follicles will be present on the conjunctiva. Although it occurs in both eyes, one eye usually seems worse.

As the disease progresses, the cornea, the clear dome-like structure on the front part of the eye, becomes inflamed. Small white lesions called subepithelial infiltrates often develop. These infiltrates are immune cell complexes that develop in response to the virus. Subepithelial infiltrates may remain for quite some time and usually do not affect vision unless they occur in the center of the cornea. In this case, people will complain of blurry vision or glare around lights.

Another complication of PCF is the development of a pseudomembrane. A pseudomembrane is a false membrane made of inflammatory debris and mucous that usually­­ forms on the conjunctiva under the upper eyelid. Pseudomembranes make people with PCF very uncomfortable. If present, doctors usually recommend removing them by using anesthetic and forceps.


Treatment of pharyngoconjunctival fever is aimed at reducing symptoms since it is considered a self-limiting disease. Self-limiting means that the illness goes through a cycle and then disappears eventually. As a result, doctors know that people with PCF will eventually feel better so treatment is designed to help manage symptoms. The ultimate goal of treatment is to make the patient feel better.

Most treatment options involve the use of artificial tears. Patients are instructed to use the drops 4-8 times per day for a few weeks. Cold compresses have been shown to alleviate symptoms. Optometrists and ophthalmologists also recommend a vasoconstrictor/antihistamine eye drop commonly described as a “get-the-red-out” drop. A vasoconstrictor with an antihistamine will help to alleviate the intense itching that some people with pharyngoconjunctival fever often develop. Pharmaceuticals are also prescribed for certain patients. Occasionally, patients may be at risk for developing a bacterial superinfection. In this case, antibiotic eye drops may be needed to avoid worsening of symptoms.

A Word From Verywell

Depending on the amount of inflammation involved and the presence of subepithelial infiltrates and pseudomembranes, steroids may be prescribed with caution. Steroids are helpful but must be used carefully and tapered over a long period of time. Steroids are not recommended in the early phase because it may actually enhance viral cell replication. Also, steroids are known to worsen underlying conditions such as herpetic eye infection that may mimic pharyngoconjunctival fever. Antivirals are being investigated for pharyngoconjunctival fever but are not commonly prescribed at this time.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. John Hopkins Medicine. Adenovirus.

  2. Chigbu DI, Labib BA. Pathogenesis and management of adenoviral keratoconjunctivitisInfect Drug Resist. 2018;11:981–993. doi:10.2147/IDR.S162669

  3. Nemours Kids Health. Adenovirus (for parents).

  4. Ghebremedhin B. Human adenovirus: Viral pathogen with increasing importance. Eur J Microbiol Immunol (Bp). 2014;4(1):26–33. doi:10.1556/EuJMI.4.2014.1.2

  5. Follicular conjunctivitis.

  6. EyeWorld. Adenoviral conjunctivitis: Identifying and treating.

  7. Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013;310(16):1721-9. doi:10.1001/jama.2013.280318

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.