What to Know About Follicular Conjunctivitis

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:

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• Chlamydiae trachomatis, the most common cause of long-term cases
• molluscum contagiosum
• adenoviruses, which can also cause upper respiratory infections
• herpes simplex virus (HSV)
• picornaviruses
• coxsackieviruses that are sometimes known to cause type 1 diabetes
• severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in limited cases, the virus that causes coronavirus disease 2019 (COVID-19)

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:

• mononucleosis (“mono”)
• herpes zoster (shingles)
• Epstein-Barr virus

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.