Follicular conjunctivitis is an eye infection. People also call it pinkeye. It is usually mild and self-limiting, meaning it tends to go away on its own.

Bacteria or viruses can cause follicular conjunctivitis. Conjunctivitis involves inflammation of the conjunctiva, or the mucus membrane that lines the eye and inside of the eyelid.

The names papillary and follicular conjunctivitis specifically refer to how the inflammation manifests. In follicular conjunctivitis, the inflammation leads to small, dome-shaped nodules called follicles.

Treatment usually focuses on easing the symptoms while the infection runs its course.

This article will explain what follicular conjunctivitis is, its symptoms, and its causes. It will also look at when it might be a good idea to speak with a doctor and how they may treat it.

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Follicular conjunctivitis is a mild eye infection. It causes inflammation, or swelling, in the conjunctiva. When bacteria cause the infection, doctors call it bacterial follicular conjunctivitis. When a virus causes the condition, doctors call it viral follicular conjunctivitis.

In cases of toxic follicular conjunctivitis, topical medications — applied directly to the eye — are usually the cause.

It can affect one or both eyes and be uncomfortable, but it is not usually serious. The infection will usually go away on its own after a few weeks. If a person develops complications, the infection can become serious.

It is best to talk with a doctor if there are any accompanying symptoms, such as fever.

Is follicular conjunctivitis contagious?

When the cause is a virus or bacteria, follicular conjunctivitis is contagious and can spread from person to person. If a topical medication causes follicular conjunctivitis, it is less likely to be contagious.

People can take certain measures to avoid transmitting the infection, such as washing their hands frequently, especially after touching the infected eye, or using separate towels and washcloths.

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The symptoms of follicular conjunctivitis will usually come on suddenly and may include:

  • feeling like something is in the eye
  • red eye or eyes
  • itchy eye or eyes
  • eyes that are sensitive to light
  • watering discharge from the eye
  • a burning sensation in the eye

People with bacterial follicular conjunctivitis may also experience a mucus-like discharge and wake up with their eyelids stuck together.

How long does follicular conjunctivitis last?

Follicular conjunctivitis will usually clear up on its own within about 3 or 4 weeks.

Contact with viruses and bacteria can cause follicular conjunctivitis.

Common viruses that can cause the infection include:

  • herpesviruses, which include:
    • the herpes simplex virus (HSV) — usually, it is HSV1 that causes herpes-associated eye infections
    • the varicella-zoster virus, which can cause chickenpox and shingles
    • the Epstein-Barr virus, which can cause “mono”
  • adenoviruses
  • rubella virus
  • rubeola, or the measles virus
  • Mollascum contagiosum virus

Common bacteria that can cause the infection include:

  • Haemophilus influenzae
  • Chlamydia trachomatis
  • Staphylococcus aureus
  • Neisseria meningitides
  • Streptococcus pneumoniae
  • Moraxella catarrhalis
  • Moraxella lacunata
  • Neisseria gonorrhea

Toxic follicular conjunctivitis

For cases of toxic follicular conjunctivitis, topical medications are the cause. These can include:

  • antiviral agents
  • atropine
  • miotics
  • sulfonamides

Follicular conjunctivitis will usually go away on its own within a few weeks without the need for medical attention.

However, the Centers for Disease Control and Prevention (CDC) recommend that people speak to a doctor if any of the following apply:

  • They experience pain in the eye or eyes.
  • They experience sensitivity to light.
  • Their vision is blurry, even after they wipe away the discharge.
  • They have very red eyes.
  • They have a weakened immune system due to an HIV infection, chemotherapy, or another factor.
  • The symptoms do not go away after a while.

Doctors will usually diagnose follicular conjunctivitis by:

  • asking the person questions about their medical history
  • asking the person questions about their symptoms
  • examining the eye

Sometimes, they may recommend microbiological tests to confirm the cause of the infection. When this is the case, the doctor will collect a sample of the eye discharge and send it to a laboratory. However, this is rare.

Most cases of bacterial and viral follicular conjunctivitis will get better on their own. There are things people can do to ease the symptoms at home in the meantime.

They include:

  • using over-the-counter (OTC) artificial tears
  • placing a warm, damp washcloth over the closed eyes for a few minutes
  • taking OTC pain relief such as ibuprofen (Advil)

If the infection does not go away on its own, doctors may recommend additional treatment. For bacterial follicular conjunctivitis, this might involve antibiotics.

For viral conjunctivitis, the treatment focuses on symptom relief — using some of the measures mentioned above — and supportive care.

To help prevent the spread of follicular conjunctivitis, the CDC recommends:

  • frequently washing hands for at least 20 seconds at a time
  • avoiding touching or rubbing the eyes while recovering from the infection
  • avoiding wearing contact lenses while recovering from an infection
  • avoiding sharing pillows, washcloths, towels, eye drops, makeup, makeup brushes, or eyeglasses
  • avoiding swimming pools while recovering from an infection

To avoid reinfection, people can clean or replace certain items. For example, disposing of any eye or face makeup, makeup brushes, contact lenses, or contact lens solution they used while recovering from the infection.

A person should also consider thoroughly cleaning eyeglasses, sunglasses, or contact lens cases when the infection clears up.

Read more about how to prevent conjunctivitis.

Follicular conjunctivitis is an infection in the mucus membrane that covers the eye and the eyelid (conjunctiva). People sometimes call it pink eye. It is usually mild and self-limiting, meaning it tends to go away on its own. Viruses or bacteria can cause it, and it is contagious.

Symptoms include red, itchy eyes, discharge from the eyes, and sensitivity to light. There are things people can do to ease the symptoms at home, such as using a clean, damp washcloth on the affected area. If the problem does not go away within a few weeks, speaking with a doctor is a good idea.