Viral Conjunctivitis Medication
- Author: Ingrid U Scott, MD, MPH; Chief Editor: Hampton Roy Sr, MD more...
Medication Summary
Medications used in the treatment of viral conjunctivitis include the following:
- Topical artificial tears - 4-8 times per day, for 1-3 weeks
- Topical vasoconstrictor/antihistamine - 4 times per day, for severe itching
- Topical steroids - For pseudomembranes and subepithelial infiltrates
- Topical antibiotic - To prevent bacterial superinfection
- Topical antiviral agents - For HSV infection
- Oral acyclovir - For VZV infection
Ocular Lubricants
Class Summary
These agents are used for symptomatic relief.
Artificial tears (Refresh Tears, Akwa Tears, Bion Tears, Murine Tears)
Artificial tears act to stabilize and thicken precorneal tear film and prolong tear film breakup time, which occurs with dry eye states.
Antihistamines
Class Summary
These agents are used to treat severe itching.
Levocabastine
Levocabastine is a potent histamine H1-receptor antagonist; it is for ophthalmic use.
Corticosteroids
Class Summary
Corticosteroids may be used for pseudomembranes and decreased vision and/or glare due to subepithelial infiltrates. They have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli. Extreme caution should be taken when using corticosteroids, as they may worsen an underlying HSV infection.
Prednisolone ophthalmic (AK-Pred, Pred Mild, Omnipred)
This agent decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability. Less potent (eg, prednisolone 0.125%, fluorometholone 0.1%) are usually sufficient to treat subepithelial infiltrates. The steroid must be tapered very slowly, over months.
Antivirals
Class Summary
These agents are used for the treatment of HSV infection.
Trifluridine (Viroptic)
Trifluridine is a pyrimidine (thymidine) analogue drug of choice in the United States for topical antiviral therapy for HSV infection. It inhibits viral replication by incorporating into viral deoxyribonucleic acid (DNA) in place of thymidine. If the patient has no response in 7-14 days, consider other treatments.
Acyclovir (Zovirax)
This is a prodrug that inhibits viral replication; it is activated by phosphorylation by virus-specific thymidine kinase.
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