How is viral conjunctivitis (pink eye) diagnosed?

Updated: Mar 24, 2020
  • Author: Ingrid U Scott, MD, MPH; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Generally, a diagnosis of viral conjunctivitis is made on the clinical features alone. Signs of acute viral conjunctivitis include inferior palpebral conjunctival follicles, tender palpable preauricular lymph node, watery discharge, red and edematous eyelids, pinpoint subconjunctival hemorrhages, punctuate keratopathy, and membrane/pseudomembrane. Intraepithelial microcysts may be an early corneal finding, which, when present, can be helpful in the diagnosis. Subepithelial corneal infiltrates may develop 1-2 weeks after the onset of the conjunctivitis. HSV infection may demonstrate the classic corneal dendrites. Extensive multiple dendrites may suggest immunocompromise (eg, due to long-term topical steroid therapy, systemic immunosuppressive medications, HIV infection).

Conventional laboratory culture identification can be expensive and time-consuming but may be helpful in certain circumstances. [6, 7, 8, 9]

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