Acute Hemorrhagic Conjunctivitis Clinical Presentation

Updated: Jan 02, 2019
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
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Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive and contagious viral infection. [8, 9]

AHC begins with an initial period of catarrhal inflammation. [10, 11] The presentation becomes more dramatic with the rapid appearance of conjunctival petechiae. These conjunctival petechiae soon coalesce to form subconjunctival hemorrhages. These are associated with a painful, rapidly progressive follicular conjunctivitis. The lids often become swollen and indurated. The infection resolves within 5-7 days, during which the symptoms of pain and irritation are present.

Punctate corneal epithelial defects have been noted and subepithelial corneal opacities have been described.

The most common manifestation of enteroviral infection is a low-grade fever of unknown etiology in infants. While concerned mainly with conjunctivitis here, it should be noted that numerous organ systems can be involved. They range from the myocardium to the central nervous system and can also include the respiratory system and the skin.


Physical Examination

The presentation of acute hemorrhagic conjunctivitis (AHC) can be dramatic. Findings include swollen lids, conjunctival follicles, chemosis, and, depending on the stage at which the patient is seen initially, subconjunctival hemorrhages, which can range from petechiae to large areas of conjunctival involvement. The cornea can exhibit superficial epithelial changes.

The symptoms also include are pain and irritation, and the lids and periocular tissues present with marked inflammation.