In recent years, ophthalmologists have been encountering an increasing number of patients with viral conjunctivitis who complain of:
- Decreased vision
- Blurriness
- Doubling of vision, discomfort, and a stabbing sensation in one or both eyes
The explanation for this phenomenon is not fully understood, but the assumption is that viral particles within the corneal tissue trigger an inflammatory response, manifesting as corneal opacities. These opacities are responsible for the symptoms reported by patients. The most effective treatment for these corneal opacities is through the use of steroid eye drops. In most cases, treatment is extended and may last for several months. Attempts to discontinue the use of steroid eye drops often lead to the return of corneal opacities. Therefore, at times, it becomes necessary to continue treatment with the minimal effective dose for months while closely monitoring the intraocular pressure and the lens of the eye. Prolonged steroid treatment can lead to elevated intraocular pressure and the development of lens opacities (cataracts).
In some cases, treatment with cyclosporine eye drops or Protopic ointment can be considered. Cyclosporine eye drops are highly concentrated and can be commercially obtained under the name Restasis, with a very low concentration of the active ingredient. This medication can also be obtained in a specially prepared solution with a much higher concentration. Protopic is a skin ointment with off-label use for various eye inflammations and may be helpful in certain cases of corneal opacities. Protopic shares a similar active ingredient structure with cyclosporine but is more potent and effective in many cases. Two issues with Protopic are that it is not approved for ocular use, yet it is being used off-label as an eye ointment, and there is an FDA warning on the packaging suggesting the potential for growths caused by the medication.