5
Table 3. Natural History of Conjunctivitis (cont'd)
Type of
Conjunctivitis Natural History Potential Sequelae
Mechanical/Irritative/Toxic (cont'd)
Medication-induced
keratoconjunctivitis
Gradual worsening with
continued use
Corneal epithelial erosion,
persistent epithelial defect,
corneal ulceration, pannus,
corneal and conjunctival
scarring
Conjunctival chalasis Chronic irritation; dry eye Redundant conjunctiva
Viral
Adenoviral Self-limited, with improvement
of symptoms and signs within
5–14 days
Mild cases: none. Severe
cases: conjunctival scarring,
symblepharon, and
subepithelial corneal infiltrates
HSV Usually subsides without
treatment within 4–7 days
unless complications occur
Epithelial keratitis, stromal
keratitis, neovascularization,
scarring, thinning, perforation,
uveitis, trabeculitis
VZV Primary infection (chicken
pox), as well as conjunctivitis
from recurrent infection,
usually subsides in a few days.
Vesicles can form at the limbus,
especially in primary infection.
e conjunctivitis is generally
papillary in nature
Necrosis and scarring from
vesicles on the eyelid margins,
conjunctiva, and in the corneal
stroma in primary disease in
children. Conjunctival scarring
from secondary infection can
lead to cicatricial ectropion.
In recurrent disease, keratitis
of the epithelium or stroma
and late corneal anesthesia or
dry eye
Molluscum
contagiosum
Conjunctivitis is associated
with eyelid lesions, which can
spontaneously resolve or persist
for months to years
Conjunctival scarring,
epithelial keratitis, pannus;
less commonly subepithelial
infiltrates/haze/scar, occlusion
of the puncta, follicular
conjunctivitis
