Rationale:

• It is important to consider other causes of conjunctival inflammation, especially in patients with suspected adenoviral conjunctivitis because of its longer course than picornaviral conjunctivitis.
• The differential diagnosis of conjunctivitis includes diseases that have both vision threatening and systemic implications.
• Herpetic eye disease, herpes zoster, and gonococcal conjunctivitis can lead to blindness if left untreated.
• Sexually transmitted causes of conjunctivitis, such as chlamydia, AIDS, syphilis, and gonorrhea need to be managed with the appropriate systemic medication.
• Other causes of the red eye, such as scleritis, may be associated with systemic autoimmune diseases.

Evidence:

• A clinical review discusses the diverse causes of conjunctivitis and their clinical differentiation (27).
• A clinical review discusses the causes of red eye (28).

Comments:

• Antigen detection, isolation, and PCR may confirm the diagnosis of herpes virus, adenovirus, or picornavirus.