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Viral conjunctivitis: a retrospective study in an Australian hospital

      Highlights

      • Most red eye patients presenting to the ED are already on antibiotics
      • About 3–5% of conjunctivitis is caused by the Herpes Simplex Virus
      • Pseudomembranous conjunctivitis is commonly caused by adenovirus

      Abstract

      Importance

      To update the literature on the current trends of viral conjunctivitis infections in Sydney, Australia.

      Background

      To find correlations between viral and patient characteristics on disease outcomes and to assess the rates of antibiotic and steroid use in patients with viral conjunctivitis prior to and after assessment by ophthalmology trainees.

      Design

      Retrospective single-centre case series.

      Participants

      368 eyes of 224 patients diagnosed with viral conjunctivitis at the Sydney Eye Hospital from 1 st January - 31 st March 2017.

      Methods

      Patients were identified from hospital records or polymerase chain reaction results.

      Results

      368 eyes of 224 patients, median age 35.3 (range 7–82) and 59.8% males, were included. 152 (67.9%) patients presented already on antibiotic treatment. Most patients (83.5%) had no previous ocular history aside from 35 (15.6%) who were regular contact lens wearers. PCR was performed in 170 (75.9%) patients, with 92 (54.1%) positive for adenovirus, and 7 (4.1%) for HSV. The average duration of symptoms prior to presentation was 6.3 days. 177 (78.0%) patients presented within 1 week of symptom onset and these patients were more likely to be adenovirus positive on PCR (OR = 2.37). Patients with symptoms of longer duration were more likely to have photophobia (OR = 2.96) and have had steroid treatment (OR = 3.80).

      Conclusions and relevance

      Patients with viral conjunctivitis typically presented within a week of symptom onset, with bilateral disease and on topical antibiotics. Pseudomembranes and a palpable preauricular lymph node were not common. As treatments emerge for viral conjunctivitis patients may need to be encouraged to present earlier.

      Keywords

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