Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Dec 25, 2024; 13(4): 97867
Published online Dec 25, 2024. doi: 10.5501/wjv.v13.i4.97867
Possible viral agents to consider in the differential diagnosis of blepharoconjunctivitis
Mutali Musa, Babatunde Ismail Bale, Ayuba Suleman, Gladness Aluyi-Osa, Ekele Chukwuyem, Fabiana D’Esposito, Caterina Gagliano, Antonio Longo, Andrea Russo, Marco Zeppieri
Mutali Musa, Babatunde Ismail Bale, Department of Optometry, University of Benin, Benin 300283, Nigeria
Mutali Musa, Ayuba Suleman, Gladness Aluyi-Osa, Department of Ophthalmology, Africa Eye Laser Centre Ltd, Benin 300105, Nigeria
Mutali Musa, Ekele Chukwuyem, Department of Ophthalmology, Centre for Sight Africa Ltd, Nkpor 434212, Nigeria
Fabiana D’Esposito, Imperial College Ophthalmic Research Group Unit, Imperial College, London NW1 5QH, United Kingdom
Fabiana D’Esposito, GENOFTA srl, Via A. Balsamo, 93, Naples 80065, Italy
Caterina Gagliano, Department of Medicine and Surgery, University of Enna "Kore", Catania 94100, Italy
Caterina Gagliano, Eye Clinic, Catania University San Marco Hospital, Catania 95121, Italy
Antonio Longo, Andrea Russo, Department of Ophthalmology, University Hospital of Catania, Catania 95123, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Musa M and Zeppieri M wrote the outline; Bale IB, Suleman AI, Aluyi-Osa G, and Zeppieri M did the research and writing of the manuscript; D’Esposito F, Gagliano C, Longo A, Russo A, Musa M, and Zeppieri M assisted in the writing of the draft and final paper; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing; Bale IB, Suleman AI, Aluyi-Osa G, D’Esposito F, Gagliano C, Longo A, Russo A, Musa M, and Zeppieri M assisted in the editing, making critical revisions of the manuscript and viewing all versions of the manuscript; All authors provided the final approval of the article.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. mark.zeppieri@asufc.sanita.fvg.it
Received: June 11, 2024
Revised: August 20, 2024
Accepted: August 27, 2024
Published online: December 25, 2024
Processing time: 128 Days and 19 Hours
Abstract
BACKGROUND

Blepharoconjunctivitis poses a diagnostic challenge due to its diverse etiology, including viral infections. Blepharoconjunctivits can be acute or chronic, self-limiting, or needing medical therapy.

AIM

To review possible viral agents crucial for accurate differential diagnosis in cases of blepharoconjunctivitis.

METHODS

The PubMed database was searched for records relating to viral blepharoconjunctivitis. The search string generated was “("virally"[All Fields] OR "virals"[All Fields] OR "virology"[MeSH Terms] OR "virology"[All Fields] OR "viral"[All Fields]) AND "Blepharoconjunctivitis"[All Fields]".

RESULTS

A total of 24 publications were generated from the search string. Reference lists from each relevant article were also searched for more information and included in this review. Viral etiologies such as adenovirus, herpes simplex virus (HSV), varicella-zoster virus (VZV), and Epstein-Barr virus (EBV) are frequently implicated. Adenoviral infections manifest with follicular conjunctivitis and preauricular lymphadenopathy, often presenting as epidemic keratoconjunctivitis. HSV and VZV infections can result in herpetic keratitis and may exhibit characteristic dendritic corneal ulcers. EBV, although less common, can cause unilateral or bilateral follicular conjunctivitis, particularly in immunocompromised individuals. Other potential viral agents, such as enteroviruses and molluscum contagiosum virus, should also be considered, especially in pediatric cases.

CONCLUSION

Prompt recognition of these viral etiologies is essential for appropriate management and prevention of complications. Thus, a thorough understanding of the clinical presentation, epidemiology, and diagnostic modalities is crucial for accurate identification and management of viral blepharoconjunctivitis.

Keywords: Viral; Blepharoconjunctivitis; Herpes simplex virus; Varicella-Zoster; Epstein-Barr

Core Tip: Viral blepharoconjunctivitis, an inflammation of the conjunctiva and eyelids caused by viral infections, represents a significant challenge in ophthalmic practice due to its highly contagious nature and potential for widespread outbreaks. The virus not only directly damages the conjunctival epithelial cells but also induces a robust inflammatory response. Understanding the molecular mechanisms underlying these interactions remains a focus of ongoing research, with implications for developing targeted therapies. The self-limiting nature of the condition, with symptoms generally resolving within two to three weeks, poses a diagnostic challenge, as it often necessitates distinguishing it from other types of conjunctivitis to prevent unnecessary use of antibiotics and to implement appropriate infection control measures.