What are the morbidities of viral conjunctivitis (pink eye)?

Updated: Mar 24, 2020
  • Author: Ingrid U Scott, MD, MPH; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Epithelial keratitis may accompany viral conjunctivitis. Punctate epithelial erosions that stain with fluorescein are commonly associated with viral keratitis. Rarely, these changes are sufficiently distinctive morphologically to allow identification of a specific type of virus as the etiologic agent. If the conjunctivitis persists or is severe, disturbances in the anterior stroma beneath the epithelial abnormalities may occur. In general, the stromal or subepithelial abnormalities are transient and resolve despite persistence of epithelial keratitis. However, in cases of specific adenoviral serotype infection, the stromal abnormalities may persist for months to years, long after the epithelial changes have resolved. In such cases, these subepithelial infiltrates are considered to be immunologic in origin, the result of antigen-antibody reaction. If they are in the pupillary axis, they may cause decreased vision and/or glare. Rarely, these corneal changes or the accompanying severe dry eye caused by partial obliteration of the conjunctival lacrimal ductules can lead to career-ending photophobia, eye pain, or visual disturbances.

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