Investigating Epstein-Barr Virus Associated Conjunctivitis

• Research type

  Research Study

• Full title

  Investigating Epstein-Barr Virus Associated Conjunctivitis

• IRAS ID

  342525

• Contact name

  Frank Larkin

• Contact email

  moorfields.resadmin@nhs.net

• Sponsor organisation

  Moorfields Eye hospital NHS foundation trust

• Duration of Study in the UK

  0 years, 8 months, 2 days

• Research summary

  Conjunctivitis means inflammation of the conjunctiva, the thin transparent layer over the white of the eye and under the eyelids. Acute conjunctivitis caused by infection is the most common condition seen in ophthalmic emergency departments, accounting for up to 10% of cases. It is responsible for 41% of eye-related general practice consultations. A diagnosis is usually made on the patient's symptoms and signs, despite this being less reliable than laboratory testing. When a cause is found, it is usually a common cold virus called adenovirus, that gets better with time and does not require treatment.

  Through investigating cases of conjunctivitis at Moorfields, we have discovered that in addition to adenovirus, Epstein-Barr virus (EBV) is sometimes detected in conjunctival swabs from individuals with conjunctivitis. EBV is a very common viral infection that 95% of adults have experienced. EBV infection mostly passes unnoticed but when symptoms do occur, they include a sore throat, high temperature, swollen glands and tiredness, often called glandular fever or infectious mononucleosis. Conjunctivitis can also occur. EBV remains in your body after infection and rarely causes further problems. The virus can become active again occasionally, which is known as reactivation. Reactivation usually passes unnoticed but sometimes is associated with recurrence of symptoms. It is possible that reactivation may cause conjunctivitis. We are not certain, which is why we are studying it, as it might be the cause of some of the conjunctivitis we see.

  Through a collaboration with University College London (UCL), we hope to gain further insight into infectious conjunctivitis, particularly in relation to EBV. This will be done by taking a swab of the conjunctiva, a single blood test and a tiny (1-2mm) tissue sample from the inner eyelid. Improved knowledge will allow us to develop better guidance and treatment for patients with conjunctivitis.

  Lay Summary of Results:

  Eye infections that cause redness and inflammation (conjunctivitis) are very common and often viral. Modern lab tests can detect many viruses at once, including Epstein–Barr virus (EBV), which causes glandular fever. However, because EBV is carried lifelong by over 95% of adults and can reactivate without symptoms, it may appear in eye samples even when it isn’t causing disease.

  In this study of 200 patients with suspected viral conjunctivitis at Moorfields Eye Hospital, EBV was found in 17% of eye swabs. Further testing of a subset of patients showed no evidence that EBV was actively infecting eye tissue or causing the inflammation. Blood tests also showed no signs of new EBV infection.
  These findings suggest that detecting EBV in eye swabs usually reflects harmless viral shedding rather than the cause of conjunctivitis. Clinicians should be cautious about attributing eye infections to EBV based on swab results alone.

  Has the registry been updated to include summary results?: No
  If yes - please enter the URL to summary results:
  If no – why not?: 31/08/2026
  Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Pending
  If yes, describe or provide URLs to disseminated materials:
  If pending, date when dissemination is expected: 31/12/2026
  If no, explain why you didn't follow it:
  Have participants been informed of the results of the study?: Pending
  If yes, describe and/or provide URLs to materials shared and how they were shared:
  If pending, date when feedback is expected: 31/12/2026
  If no, explain why they haven't:
  Have you enabled sharing of study data with others?: No
  If yes, describe or provide URLs to how it has been shared:
  If no, explain why sharing hasn't been enabled: The results will be shared as per IRAS on the public register and publications.
  Have you enabled sharing of tissue samples and associated data with others?: No
  If yes, describe or provide a URL:
  If no, explain why: The results will be shared as per IRAS on the public register and publications.
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• REC name

  Yorkshire & The Humber - Leeds West Research Ethics Committee

• REC reference

  24/YH/0160

• Date of REC Opinion

  16 Aug 2024

• REC opinion

  Favourable Opinion