What Is Viral Conjunctivitis?

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. Most viruses that cause conjunctivitis spread through hand-to-eye contact through hands or objects that have been contaminated with the virus. 

This type of conjunctivitis is responsible for the majority of infectious conjunctivitis, accounting for up to 75% of cases. Viral conjunctivitis can be accompanied by the flu or other conditions. Symptoms include watery discharge, light sensitivity, and general eye irritation. To distinguish between the different types of conjunctivitis, your doctor will need to perform lab tests to provide a definitive diagnosis.

Symptoms

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

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

Causes

Viral conjunctivitis is most commonly caused by adenoviruses, which 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 and is marked by common cold symptoms like sore throat or headache
• Epidemic keratoconjunctivitis: This can be severe and affects the cornea. It can come in the form of watery discharge, hyperemia, chemosis, and ipsilateral lymphadenopathy. This 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 catch 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.

Diagnosis

Your general physician or family doctor would 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 doctor can usually pinpoint what is causing your pink eye by examining your eye and asking about your medical history, including how your symptoms came out 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 doctor may want to perform an eye culture to determine the cause. Your doctor 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.

Treatment

Viral conjunctivitis may go away on its own after a few days or up to two weeks. Treatment therefore focuses mainly on symptom relief. Your doctor 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 doctor may ask you to carefully disinfect or throw away those lenses and even their cases

Your doctor may prescribe steroid drops to lessen the discomfort from more serious inflammations, or, in the case of Herpes virus, an anti-viral medication.

It's suggested that you stay away from your workplace or school until symptoms clear. Generally, this would be once your eyes no longer appear reddened and irritated and discharge is no longer visible. Doctors 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 person's specific case.

Make sure you practice good hygiene, from regularly washing hands to avoid touching communal surfaces and utensils, while in the company of others to prevent spreading the viruses. Keep in mind you can spread the virus as long as you have symptoms.

A Word From Verywell

Viral conjunctivitis can be a disruption to day-to-day life. Much like the common cold or any other viral infection, however, it 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. As always, if your symptoms get worse or you experience sudden, drastic changes to your vision, consult your eye doctor.