Follicular conjunctivitis is usually due to infection from a virus or the bacterium that causes chlamydia. It can spread easily but is usually mild and goes away within a few weeks.

Conjunctivitis is inflammation of the conjunctiva, the thin membrane that covers your eye and the inside of your eyelid. Infection or exposure to an irritant can cause it to become inflamed. Conjunctivitis is often called pink eye.

Depending on how the inflammation looks, doctors or healthcare professionals can usually categorize conjunctivitis as either papillary or follicular. In papillary conjunctivitis, small flat-topped nodules (papillae) form on your conjunctiva. In follicular conjunctivitis, the inflammation results in tiny dome-shaped nodules (follicles).

Follicular conjunctivitis usually suggests that a virus is the cause. Although bacteria are usually linked to papillary conjunctivitis, the bacterium that causes chlamydia, a common sexually transmitted infection, also causes follicular conjunctivitis.

Read on to learn more about what can increase your risk of follicular conjunctivitis, what symptoms to watch out for, and how doctors diagnose and treat it.

Certain kinds of bacteria or viruses most commonly cause follicular conjunctivitis. These often spread easily through touch or by air and include:

Reactions to topical medications on your eye can also cause follicular conjunctivitis. This type is called toxic follicular conjunctivitis.

In rare cases, exposure to infections from pets, such as cats, can also cause follicular conjunctivitis.

Some infections that can increase your risk of follicular conjunctivitis include:

Conjunctivitis in newborns

If a birthing parent has a chlamydia infection at the time of delivery, the newborn may be at risk of developing neonatal conjunctivitis. Doctors usually test for this to ensure a safe delivery, but it’s best to talk with a doctor about it anyway.

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Some of the most common symptoms of follicular conjunctivitis include:

  • feeling like something’s stuck in your eye
  • pain in or around your eye
  • red eyes
  • itchy eyes
  • sensitivity to light (photophobia)
  • burning eyes
  • eye discharge that can range from thin and watery to thick and sludgy
  • crusty buildup around the outer edges of your eyelids (mattering)
  • inflammation of the oil glands around your eyelids (blepharitis)

Some types of follicular conjunctivitis can cause severe symptoms elsewhere in your body. Get immediate medical help if you notice:

  • excessive watering or fluid buildup around your eyes
  • fluid-filled blisters around your eyes (epiphora)
  • bleeding around your eyelids
  • fever
  • feeling exhausted for no obvious reason
  • pain in your arms and legs
  • sore and swollen throat
  • cough that won’t go away
  • difficulty breathing

An eye doctor is usually the best specialist to diagnose and treat follicular conjunctivitis.

The eye doctor can examine your eyes using a slit lamp and other tools to look closely at your eye and the surrounding area for symptoms.

They may also take a swab of your eye to test fluid for the presence of bacteria and viruses. They may ask you to do this at their office or in a laboratory that can usually provide a definitive diagnosis of follicular conjunctivitis.

Follicular conjunctivitis usually goes away on its own in about 3 weeks or less without any need for treatment. When due to a viral infection, the virus will shed as you produce tears and eventually disappear from the area entirely.

Most treatments aim to help relieve pain or irritation from the infection. This may involve using eye drops 4 to 10 times a day to keep your eye lubricated and reduce irritation. You may also apply a cold compress to the area around your affected eye.

A doctor may recommend medical treatments for more severe or long lasting cases, such as:

  • antibiotics, such as azithromycin, for chlamydia infections
  • prescription-strength topical corticosteroid eyedrops to help reduce inflammation around the affected area
  • povidone-iodine to disinfect the area if the infection is due to an adenovirus
  • using a small cotton swab or forceps to peel off any membrane formation from your eye or eyelid, especially when due to a molluscum contagiosum infection

Is follicular conjunctivitis serious?

Most cases of follicular conjunctivitis aren’t a cause for concern. The infection goes away in a few weeks without causing any severe symptoms or long-term effects.

The side effects and complications of long-term bacterial and viral infections can be serious though. Get medical attention as soon as possible if you start to notice changes in your eyes and other symptoms such as fever, body aches, or difficulty seeing.

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Follicular conjunctivitis lasts between 14 and 30 days on average. It’s usually most contagious during the first 10 to 14 days after you’ve contracted the infection.

Whether you or someone close to you has an active infection, here are some tips to prevent the spread of the infection:

  • Avoid touching your eyes.
  • Don’t share any objects that may touch your eyes.
  • Avoid swimming in public pools or using shared facilities such as Jacuzzis or steam rooms where bacteria or viruses can spread through droplets in the air.
  • Wash your hands frequently with soap and water for 20 seconds.
  • Clean and sterilize your glasses regularly to avoid contact with bacteria or viruses that may get on the surfaces of your glasses.
  • Consider switching to single-use contact lenses to avoid reusing any.
  • Avoid sexual contact with people who have an active infection.

Here are some of the most common questions about follicular conjunctivitis.

Is follicular conjunctivitis contagious?

Follicular conjunctivitis is very contagious in the first week or two after infection. If someone touches your infected area and then touches their own eyes, the infection can be spread immediately.

Do I need to quarantine with follicular conjunctivitis?

You don’t have to quarantine with follicular conjunctivitis. But it can help keep the infection from spreading.

Practice good hygiene, such as washing your hands and not sharing towels or clothes with others. This can reduce the risk of the infection spreading without the need for isolation.

Will follicular conjunctivitis go away on its own?

Follicular conjunctivitis usually goes away on its own. Chronic cases that last longer than 3 or 4 weeks may need medical attention.

Follicular conjunctivitis is a mild eye infection most commonly due to a bacterial or viral infection. Chlamydia and molluscum contagioscum are among the most common causes.

Follicular conjunctivitis is typically a short-term infection that goes away after a few weeks without treatment. But get medical help if you notice any other symptoms such as body aches, fever, or significant changes in your vision.