Last reviewed: May 2019
Last updated: January  2018



History and exam

Key diagnostic factors

  • presence of risk factors
  • watery discharge
  • ropy, mucoid discharge
  • purulent discharge
  • itching predominant symptom
  • eyelids stuck together in morning
  • tender, pre-auricular lymphadenopathy

Other diagnostic factors

  • conjunctival follicles
  • superficial punctate keratopathy
  • unilateral disease
  • corneal subepithelial infiltrates
  • corneal pannus
  • vesicular skin rash

Risk factors

  • exposure to infected person
  • infection in one eye
  • environmental irritants
  • allergen exposure
  • camps, swimming pools, military bases
  • Asian or Mediterranean young male
  • atopy
  • asthma
  • hay fever
  • contact lens use
  • ocular prosthesis
  • topical eye medicine
  • oral antihistamine/anticholinergic drugs
  • sebaceous gland carcinoma
  • mechanical irritation
  • history of rheumatological disease

Diagnostic investigations

1st investigations to order

  • rapid adenovirus immunoassay
Full details

Investigations to consider

  • cell culture
  • Gram stain
  • PCR
  • ocular pH
Full details

Treatment algorithm


Authors VIEW ALL

Fellowship-Trained Ophthalmologist

Manatee Sarasota Eye Clinic & Laser Center


Chief Medical Officer

Rapid Pathogen Screening Inc.




RS is Chief Medical Officer at Rapid Pathogen Screening, Inc, which is the manufacturer of AdenoPlus, and also has stock in the company. He serves as an advisory board member for Allergan, the manufacturer of gatifloxacin, and NovaBay Pharmaceuticals, Inc, the manufacturer of aganocides.

Dr Robert Sambursky would like to gratefully acknowledge Dr Lee Raykovicz, a previous contributor to this monograph. LR is Director of Clinical Relations, Rapid Pathogen Screening, Inc.

Peer reviewers VIEW ALL


Cornea, External Disease & Refractive Surgery

Long Island College Hospital Eye Center

Assistant Professor of Ophthalmology

SUNY Downstate Medical Center




ME declares that he has no competing interests.

Consultant Ophthalmologist

Sunderland Eye Infirmary




SF declares that he has no competing interests.

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