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Viral Conjunctivitis Medication

  • Author: Ingrid U Scott, MD, MPH; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Nov 05, 2015

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.



Class Summary

These agents are used to treat severe itching.



Levocabastine is a potent histamine H1-receptor antagonist; it is for ophthalmic use.



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.



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.

Contributor Information and Disclosures

Ingrid U Scott, MD, MPH Professor, Department of Ophthalmology and Public Health Sciences, Pennsylvania State University College of Medicine

Ingrid U Scott, MD, MPH is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, American Medical Association, American Society of Cataract and Refractive Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.


Kevin Luu, MD Consulting Staff, Pediatric Anesthesia Associates Medical Group, Inc; Consulting Staff, Children's Hospital of Central California

Kevin Luu, MD is a member of the following medical societies: Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Jerre Freeman, MD Founder and Chairman, Memphis Eye and Cataract Associates; Clinical Professor, Department of Ophthalmology, University of Tennessee Health Science Center College of Medicine

Jerre Freeman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Tennessee Medical Association

Disclosure: Nothing to disclose.

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Viral conjunctivitis. Image courtesy of Wikimedia Commons.
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