Acute Hemorrhagic Conjunctivitis: Causes, Symptoms & Treatment

Acute hemorrhagic conjunctivitis is a highly infectious form of conjunctivitis with typical sudden onset. The clinical variance from other types of conjunctivitis is its hemorrhagic form. It means there is bleeding from the blood vessels of conjunctiva. Conjunctivitis is inflammation of conjunctiva of the eye, a thin layer that covers the white of an eye. Infection is caused by coxsackie virus A24 and enterovirus 70. In this condition one or both the eyes can be affected.

The symptoms manifest as red inflamed eyes with profuse itching and irritation along with watering. Spread of the disease can occur rapidly in closed environment such as office and school.

Acute hemorrhagic conjunctivitis usually lasts for 7 days. The disease is self limited. Treatment is symptomatic having satisfactory prognosis.

Causes Of Acute Hemorrhagic Conjunctivitis

Acute hemorrhagic conjunctivitis is an infectious disease affecting eyes. It is caused by coxsackie virus A 24 and enterovirus 70. Sometimes EB virus is also known to be a causative factor. Children as well as adults both can be affected with the virus. Infection lasts for a week. It remains contagious throughout 7 days till the eye returns back to normal.

Transmission of the infection occurs through direct contact with infected patient or contact with the materials used by the infected patient such as clothes etc.

Spread can also occur through feco-oral route especially in places having poor sanitation. High humid atmosphere, overcrowding, poor healthcare facilities increases the risk for epidemics of acute hemorrhagic conjunctivitis.

Symptoms Of Acute Hemorrhagic Conjunctivitis

The symptoms of acute hemorrhagic conjunctivitis are abrupt in onset. They develop within 12 -24 hours after the person is infected. Infection can occur in one or both the eyes.

  • Severe itching and reddening of the eye.
  • Itching and redness may begin in one eye and spread rapidly to other eye.
  • Pain in the affected eye.
  • The layer of conjunctiva becomes fiery red due to leakage of blood from the vessels into the subconjunctival space.
  • Development of crusts on the eyelid which makes the lid swollen and sticky, especially when waking up in the morning.
  • Gritty feeling in the eye.
  • Intense watering from eyes.
  • Visual blurring.
  • Increased sensitivity to light.
  • Onset of mild fever in first one or two days.

All the above symptoms can cause extreme discomfort to the patient. Although rare, complications can develop. They can be as follows:

  • Severe and unbearable pain in the eye.
  • Development of ulcer on cornea.
  • Loss of vision due to ulceration and scar on cornea.
  • Bacterial infection occurring concomitantly with viral infection.
  • It may affect vital organs such as skin, respiratory system, nervous system etc.

Treatment Of Acute Hemorrhagic Conjunctivitis

Acute hemorrhagic conjunctivitis is a self limited disease which usually lasts for 7 to 10 days. The onset is rapid and resolution of the symptom begins from the third day onwards till the eye becomes clear and normal. There is no specific treatment for this condition. The aim of treatment is to allay the distressing symptoms.

  • Patient feels better by applying warm compresses. It helps to alleviate pain, swelling and itching.
  • Clean the crust formed with wet cotton ball daily in the morning. If both the eyes are infected use different swabs for both the eyes.
  • Contact lens must not be used. Patient having refractory error must wear glasses during this period.
  • Some patients find relief with use of lubricating drops.
  • Often ophthalmologists prescribe antibacterial eye drops to reduce the risk of secondary bacterial infection.
  • Topical use of corticosteroid eye drops if cornea and iris is damaged.
  • Anti viral drugs are not used in majority of cases.

Patient must stay away from direct sunlight or visiting places full of dust and smoke.