Adenoviral conjunctivitis

Adenoviral conjunctivitis is caused by adenoviruses of serotypes 3, 4, 7, 10. Eye disease is preceded or accompanied by damage to the upper respiratory tract (rhinitis, pharyngitis, nasopharyngitis, tonsillitis). Adenoviral conjunctivitis usually occurs in children's groups. Transmission adenovirus occurs by airborne droppings, less commonly by contact. The duration of the incubation period is 3-10 days.

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Symptoms of adenoviral conjunctivitis

Adenoviral conjunctivitis begins acutely, usually in one eye, after 1-3 days the other eye may get sick. Discharge at the edges of the eyelids and on the conjunctiva scanty, slimy character. The conjunctiva of the eyelids and transitional folds is hyperemic, edematous, with more or less follicular reaction and with the formation of easily removable films on the conjunctiva of the eyelids (usually in children). Depending on the severity of these symptoms, catarrhal, follicular and membranous forms of adenoviral conjunctivitis are distinguished. Corneal lesions are found in 13% of cases and have the character of superficial, small, point infiltrates staining with fluorescein. The phenomena of keratitis usually disappear completely upon recovery, which occurs within 2-4 weeks.

Adenoviral conjunctivitis is characterized by common symptoms: lesions of the respiratory tract with fever and headache. Systemic damage may precede eye disease. The duration of adenoviral conjunctivitis is 2 weeks.

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Treatment of adenoviral conjunctivitis

Treatment of adenoviral conjunctivitis complex. It should be noted that treatment can be difficult, as today there is no means that would selectively affect adenoviruses.

Treatment may be variable and depends on the possible ophthalmic complications, is a form of viral infection.

If one of the thirty well-known medicine of adenoviruses penetrates into the mucous membrane of the nasopharynx, then in 3-5 days it affects the eye conjunctiva. Although pediatric ophthalmologists and pediatricians are inclined to believe that adenovirus gets into the eye through dirty hands that a child touches infected toys, dishes or common hygiene items - towels, handkerchiefs, and so on. As a rule, the conjunctiva of one eye suffers, the second eye “joins” after a few days. Symptoms of ophthalmic adenovirus are clinically manifested in the form of burning and cutting in the eye, often children complain of an invisible speck that is actually absent. The mucous membrane of the affected eye swells and reddens, increased tearing appears. Conjunctivitis of viral etiology can cause headache, swelling of the lymph parotid nodes, and if it is not treated with adequate drugs, the discharge is so abundant that the child cannot open his eyes in the literal sense with pus in the morning.

Many parents believe that adenovirus conjunctivitis can be treated by home methods, when the child is washed with weak tea, or with a solution of boric acid, especially well-read adults rush to the pharmacy for shopping and get albumin to eliminate the seemingly obvious eye infection. But antibiotics and corticosteroids do not have the desired effect on the virus, and viral conjunctivitis continues to develop and sometimes even worsen. Perhaps the formation of keratoconjunctivitis, when the inflammatory process moves to the cornea of the eye, the eyelid swells and closes the eye slit, photophobia develops. In severe corneal lesions, the child’s vision may drop by almost 30%, which may require inpatient treatment and even surgery. In order to prevent such situations, parents with the slightest signs of viral eye damage should contact a pediatrician or pediatric ophthalmologist.

Treatment of adenoviral conjunctivitis involves the use of such drugs, which act not only on the virus, but also do not damage the mucous membrane of the eye. The fact is that the virus has a tendency to “hide” in the cells of the tissues in order to neutralize it; drops are necessary, which include leukocyte human interferon.

Before you visit a doctor, you should familiarize yourself with and follow the following simple rules: 

• It is necessary to allocate separate hygiene items for a sick child - a towel, pillow, soap, as well as dishes. Pipette for instillation of drops should be intended only for the child, as well as other attributes of the treatment - tampons, handkerchiefs, napkins. 
• Those who care for a sick child need to wash their hands with soap and water regularly, this is enough not to transfer the virus to others and to themselves. 
• Pipette, glass rod for laying ointment, dishes should be processed by boiling. The virus can not be neutralized with alcohol, but at high temperatures it dies. 
• The room where the sick child is located should be aired and a normal level of humidity should be provided in it; it is advisable to darken (shade) the windows for several days when the eye is irritated by light.

Adenoviral conjunctivitis, the treatment of which still does not have a single approved scheme, in mild form does not require the use of complex eye drops. Enough interferon therapy, tonic, immunomodulatory agents and hygiene in order for the body within 10 days independently coped with the virus and its manifestations. However, there are also protracted forms of the disease when drugs of broad antiviral effect are used, for example, laferon. Instillation in the first seven days is carried out quite often - up to 8 times a day, then the frequency is reduced to 2-3 times. If adenoviral conjunctivitis is accompanied by purulent secretions, antibacterial drops are shown to reduce the risk of developing secondary infection. Also effective antihistamines with vasoconstrictor properties. With photophobia syndrome and dryness of the mucous membrane, artificial moisturizers, such as Oftagel, are prescribed.

Adenoviral conjunctivitis is treated with the help of interferon, DNA-ase or semianz instillations (6-10 times a day) and antiallergic eye drops, and if there is insufficient tear fluid, artificial tears or ofgel.

To prevent the development of a secondary bacterial infection, antibacterial solutions should be instilled (for example, Maxstrol eye drops). The duration of treatment is at least 2 weeks.

Recurrent adenoviral conjunctivitis is treated by the use of immunocorrective methods. Tactivin (6 injections in a dosage of 25 µg), levamisole - 150 mg 1 time / week and cycloferon (10 injections, 2 ml each) are included in the therapy.

In the ophthalmologic practice of treating adenoviral infections of the eye, the following drugs are considered effective, which only the physician should choose, taking into account the individual characteristics of the child’s condition and the severity of the disease: 

• Poludan is a drug, interferon stimulator, intended for the treatment of adenoviral conjunctivitis, keratoconjunctivitis and keratitis. 
• Florenal - neutralizes viruses, mainly the group Herpessimplex. 
• Interferon is an antiviral and immuno-activating agent, produced in the form of a powder, from which it is necessary to prepare a solution. 
• Tebrofen - in the form of drops or ointment, antiviral drug. 
• Floksal - antimicrobial drops based on ofloxacin. 
• Albucidum - broad-spectrum antimicrobial drops. 
• Tobrex - antimicrobial drops that can be prescribed from the first day of birth. 
• Vitabact is a preparation based on picloxidine hydrochloride, which has an aseptic effect. Drops are designed to treat a viral and microbial infection from the first birthday.

Treatment of adenoviral conjunctivitis is carried out only under the supervision of a physician, as an incorrectly chosen drug can aggravate the course of the disease. The prognosis of ophthalmic forms of adenoviral diseases is generally favorable. Conjunctivitis in an uncomplicated form can pass on its own, while respecting personal hygiene, aseptic procedures and taking immunomodulators. More complex cases of the disease do not last more than a month, relapses are also extremely rare.

Adenoviral conjunctivitis has a favorable prognosis.