Acute hemorrhagic conjunctivitis, or AHC, is a distinct and highly contagious form of eye infection. It is a severe type of conjunctivitis, often called “pink eye,” marked by its sudden onset and characteristic bleeding within the conjunctiva, the thin membrane covering the white of the eye and the inner eyelid. This bleeding gives the eye a vivid red appearance. AHC is known for spreading rapidly through communities.
Symptoms and Causes
The onset of acute hemorrhagic conjunctivitis symptoms is abrupt and intense. Individuals experience significant eye pain, a persistent feeling of having a foreign object in the eye, and excessive, watery discharge. Swelling of the eyelids and the conjunctival tissue (chemosis) is also common. Many people also develop a pronounced sensitivity to light, known as photophobia, and may have blurred vision or a fever.
The defining sign of AHC is subconjunctival hemorrhage, which distinguishes it from more common forms of pink eye. This occurs when small blood vessels under the conjunctiva rupture, causing blood to pool and create dramatic red patches on the white of the eye. The combination of pain, swelling, and bleeding can be alarming for those who contract it.
This eye infection is caused by specific types of viruses. The two primary culprits are Enterovirus 70 (EV70) and a variant of Coxsackievirus A24 (CA24v), which are responsible for the intense inflammatory response. Adenovirus 11 has also been identified as a cause in some instances. These viruses are hardy and can survive on surfaces, contributing to their efficient spread.
Transmission and Contagiousness
The viruses that cause AHC are exceptionally contagious, leading to rapid and widespread outbreaks, especially in densely populated areas or places with inadequate sanitation. The primary method of transmission is through direct contact with the eye secretions of an infected individual. Touching the eye after contact with a person who has the virus is a common way the infection spreads.
Indirect contact is another mode of transmission. The virus can be transferred through contaminated objects, known as fomites. Sharing personal items like towels, makeup, or pillowcases with an infected person can spread the virus. It can also be passed through hand-to-eye contact after touching contaminated surfaces like doorknobs.
The contagious period for AHC is long. An individual can spread the virus before showing symptoms and can remain contagious for up to two weeks. This extended period of communicability contributes to its ability to cause large-scale epidemics. The short incubation period of one to two days means symptoms appear quickly after exposure, further fueling transmission within households and communities.
Management and Treatment
Because AHC is a viral infection, there is no specific medication to eliminate the virus. Antibiotic eye drops, which fight bacteria, are ineffective against the viruses that cause AHC. Antibiotics are only prescribed if a secondary bacterial infection develops, which is not a standard treatment for the initial condition.
Treatment focuses on supportive care to manage discomfort while the infection runs its course. Applying cold compresses to the eyes can help reduce swelling and provide pain relief. Using over-the-counter lubricating eye drops, or artificial tears, can soothe irritation. It is also important to rest the eyes and avoid bright lights if photophobia is present.
Proper hygiene is essential for managing AHC and preventing its spread. This includes frequent handwashing with soap and water, especially after touching the eyes, and avoiding sharing personal items like towels or bedding. A person with AHC should avoid touching their eyes. Seeking medical advice is recommended if there is severe pain, a significant change in vision, or if symptoms do not improve.
Recovery and Potential Complications
For most people, acute hemorrhagic conjunctivitis is a self-limiting illness that resolves on its own within one to two weeks. During this time, the symptoms will gradually subside. The redness from the hemorrhages will fade as the body reabsorbs the blood, and vision returns to normal without any lasting effects.
Although recovery is usually complete, rare but serious complications have been documented. In a very small number of cases, particularly those caused by Enterovirus 70, neurological issues have been reported. This can include a polio-like paralysis known as radiculomyelitis. This outcome is extremely uncommon and not a typical feature of the infection.