The Influenza epidemic of 2018 has been one of the most widespread and dangerous so far. Although it is currently not known why this season is so severe, it is often due to incomplete coverage of vaccinations leading to reduced effectiveness as new or mutated strains of the influenza virus are not covered by the vaccinations people have received.

The influenza virus very commonly affects the eyes causing some of the most severe and contagious conjunctivitis (pink eye). Influenza affects the mucous membranes of the body and all these membranes are interconnected. Hence infection in the nose and throat can easily get into the mucous membranes (conjunctiva) which cover the surface of the eyes and lining of the eyelids. Initial symptoms may actually start in the eyes and move on to other parts of the body or vice versa.

There are many types of conjunctivitis and it is often difficult to differentiate between the types. Viral conjunctivitis usually is associated with a fever and overall congestion of the upper respiratory tract. Swollen lymph nodes in front of the ears are a telltale sign of viral conjunctivitis.

Ocular symptoms usually include an overall swelling and redness of the sclera (white of the eye) and deep red inflammation of the tissue inside of the eyelids. Usually a clear or white discharge is present. Swelling and drooping of the eyelids may also be present. Usually one eye is affected first with the other being affected in the next 2 to 3 days. This differs from bacterial conjunctivitis which usually has deep green eye chunks or matter in the eyes. Usually there is not a fever or overall congestion with bacterial conjunctivitis. This type of conjunctivitis is most common in children and not seen very often in adults.

Viral conjunctivitis is extremely contagious. Good handwashing is a must. Studies have also shown that twice daily use of an antiseptic gargling solution can be very effective in killing the influenza virus before it has a chance to start replicating and moving into other areas including your eyes. Never use any antiseptic in your eyes!

Antibiotics for viral conjunctivitis are not effective. Most viral conjunctivitis including the current strains are running a 2 to 3 week cycle. Similar to treating systemic symptoms, decongestants, pain and fever reducing medications, rest and plenty of water can also relieve some symptoms of viral conjunctivitis but the virus will still run its course. I usually recommend a 10 to 20 day taper of steroid eyedrops to reduce swelling and prevent possible scarring of the surface of the eyes. This treatment needs to be monitored for effectiveness and watch for any possible side effects of the steroids.  Lubrication drops and cold compresses can also be helpful. Visine is never effective for any eye condition, it only makes your eyes look less red for a short period of time.

Emergency room staff and urgent care clinics are not equipped to differentially diagnose between influenza viral conjunctivitis and other types of conjunctivitis. They are also not qualified to prescribe steroid eyedrops. If you feel that you may have symptoms of viral conjunctivitis, please give our office a call or see an eye doctor in your area.

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