Eye
Conjunctiva
Conjunctivitis
Acute hemorrhagic conjunctivitis
Author: Deepali Jain, M.D.
Last author update: 1 September 2013
Last staff update: 18 December 2020
Copyright: 2004-2025, PathologyOutlines.com, Inc.
PubMed Search: Acute hemorrhagic conjunctivitis [title]
Table of Contents
Terminology | Epidemiology | Sites | Pathophysiology | Etiology | Clinical features | Diagnosis | Laboratory | Treatment | Clinical images | Microscopic (histologic) descriptionCite this page: Jain D. Acute hemorrhagic conjunctivitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeacutehemorrhagic.html. Accessed January 10th, 2025.
Terminology
- Also known as Apollo disease
Epidemiology
- First described in Ghana in 1969
- Most common in developing countries, may affect > 50% of local population
Sites
- Palpebral conjunctiva; cornea may be involved with a fine punctate keratopathy and rarely subepithelial opacities (eMedicine: Acute Hemorrhagic Conjunctivitis [Accessed 24 April 2018])
Pathophysiology
- Epidemic form is rapidly progressive and highly contagious
Etiology
- Most commonly human coxsackievirus A24 variant (CV-A24v, Arch Virol 2007;152:2005, J Med Virol 2007;79:748, MMWR Morb Mortal Wkly Rep 2004;53:632, Virol J 2013;10:96) or human enterovirus 70 (EV-70, Emerg Infect Dis 1999;5(2)); less frequently adenovirus serotype 11
Clinical features
- Ocular pain, eyelid swelling, tearing, foreign body sensation or irritation, photophobia and conjunctival hemorrhages
- Associated with polio-like paralysis
Diagnosis
- RT-PCR (J Virol Methods 2007;142:89, J Clin Microbiol 2005;43:1069), culture
Laboratory
- Eye mucous swab samples
Treatment
- Symptomatic, usually self-limited after 5 - 7 days with no sequelae
- Patient education to avoid spread
Clinical images
Images hosted on other servers:
Microscopic (histologic) description
- Palpebral conjunctival follicular reaction
- Subconjunctival hemorrhage ranging from petechiae to large areas, and congestion
- Fine pinpoint epithelial keratitis
