Acute hemorrhagic conjunctivitis is a severe form of viral pink eye that could cause eyelid swelling, eye discharge, and bleeding. There’s no cure, but treatments can help you manage the symptoms until the virus clears.

Conjunctivitis (“pink eye”) is inflammation of your conjunctiva, the thin membrane that covers your eyeball and inner eyelid. This inflammation is usually due to an infection, allergen, or toxin. Certain viruses can cause a specific type of conjunctivitis called acute hemorrhagic conjunctivitis (AHC).

In parts of West Africa, AHC is sometimes called “Apollo 11 disease” because scientists first discovered it in Ghana in 1969, the year of the moon landing.

AHC is typically much more severe than other types of conjunctivitis. Symptoms can include painful swelling and noticeable bleeding in and around your eye. Get medical help as soon as possible if you think you have AHC.

Read on to learn more about the symptoms of AHC, who may be at a higher risk, and how doctors diagnose and treat it.

Specific virus types can cause AHC, most notably:

Conjunctivitis is highly contagious. AHC is usually transmitted through hand-to-eye contact, meaning you touch an infected surface or object and then touch your eye. You can also contract the infection by using an object that carries the virus on your eyes, such as a towel or makeup tool.

Additionally, adenoviruses can spread through infected particles in the air that can land on or around your eyes.

Viruses that cause AHC can also be spread when infectious material from fecal matter reaches your eyes. This can happen if you touch your eyes after coming in contact with infected waste, such as after using the bathroom or changing a diaper.

AHC is most common in areas where indoor plumbing isn’t widespread and where people live close together. This is because infectious material can spread through the air in high concentrations or seep into shared water resources.

A 2020 study that looked at outbreaks in the Hunan province of China between 2007 and 2016 suggested that AHC cases were more easily spread in schools, from primary school through college, from July to September.

You’re more likely to get AHC if you frequently go into public facilities such as gyms, bathrooms, and saunas, where body fluids are commonly transferred onto shared surfaces.

It’s important to sanitize surfaces such as exercise equipment, door handles, and faucets to avoid transferring bacteria or viral material to your eyes.

Symptoms of AHC usually come on suddenly. Common symptoms of AHC include:

  • a feeling that something is in your eye
  • watery eyes
  • swollen eyelids
  • fluid-filled, blister-like growths on top of the eye surface (chemosis)
  • bleeding from blood vessels below the eye surface (subconjunctival hemorrhage)
  • blurring of vision or difficulty seeing
  • sensitivity to light (photophobia)
  • fever

The earliest symptoms of AHC may be mild. But symptoms such as chemosis and hemorrhaging can become very painful and cause your eye to look bloodshot or completely red as blood leaks into the tissues under the eye’s surface.

In extremely rare cases of infection with enterovirus D70, AHC can cause permanent paralysis in the legs, similar to what happens in polio.

Visit an eye doctor if you have symptoms of AHC or any other type of conjunctivitis. The doctor will likely look at your eye with a slit lamp, which can give them a close-up view of your eye and the surrounding tissues.

Symptoms such as swelling, redness, and discharge are usually enough to allow an eye doctor to confidently diagnose pink eye. Watery discharge often indicates a viral infection such as AHC, while thicker discharge can mean you have a bacterial infection.

Still, the doctor may need to take a sample of cells from your conjunctiva with a cotton swab to identify the exact cause.

Most cases of AHC don’t need treatment. They go away on their own in about a week.

There’s no cure for AHC, so most treatments aim to relieve the symptoms while the infection runs its course. Treatment options include:

  • cold compresses to relieve pain and swelling
  • eye drops to help lubricate the eye and promote tears that can help reduce the concentration of infectious material
  • medications to reduce pain, such as ibuprofen (Advil)

A doctor may warn against using any over-the-counter or prescription treatments, such as topical corticosteroids, that otherwise might be used to treat pink eye. This is because steroids can cause superinfections to develop on the eye’s surface, which need separate treatment with antibiotics or antifungal medications.

Most cases of AHC last 5 to 7 days before symptoms start to go away.

However, the virus can still be contagious even after your symptoms subside.

Will AHC go away on its own?

AHC usually goes away on its own.

Even when symptoms are painful or severe, the average case of AHC goes away in about a week without any need for medical treatment.

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Here are some tips to help prevent yourself from getting AHC and spreading it to others if you have an active infection:

  • Wash your hands regularly with soap and water for at least 20 seconds.
  • Try not to touch or rub your eyes unless you’ve washed your hands.
  • Don’t share towels, makeup tools, exercise equipment, or other commonly shared objects with someone who has an infection or if you have an infection.
  • Throw away any mascara or eyeliner that may be contaminated.
  • Avoid swimming in public pools or using shared hot tubs or steam rooms, where infectious particles can easily spread.
  • Clean your glasses regularly to avoid transferring infectious material from your eyes to your glasses.
  • Don’t wear contact lenses while you have an infection.
  • Avoid reusing contact lenses. Consider switching to single-use lenses if you don’t already use them.
  • Once your infection has gone away, wash all bedding that you came into contact with while you had the infection.

AHC is a form of viral conjunctivitis that can cause more severe pain and redness than most other forms of pink eye. Symptoms come on quickly but typically go away on their own within a week.

Most cases of AHC go away without any treatment, but you should visit an eye doctor or primary care specialist if you have a fever or experience pain that disrupts your life.