Epidemic keratoconjunctivitis

Background

Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
Caused by adenovirus infection that is highly contagious and tends to occur in epidemics
- Highly contageous and potentially vision-threatening^[1]
- Transmitted via contact with infectious fluids (commonly tear fluid) on hands, tissues, etc^[1]

Subepithelial infiltrates in EKC

Ranges from subclinical conjunctivitis to severe disease with superimposed bacterial infection and systemic symptoms.^[1]
Can be preceded by prodrome of cough, fever, malaise, myalgias, nausea/vomiting
Worsening foreign body sensation (starts near medial canthus and spreads laterally), followed by^[1]:
- Lid swelling
- Tearing
- Itching
- Photophobia
- Blurred vision
- Conjunctival injection
- Papillae of inf palpebral conjunctiva
- Ipsilateral pre-auricular lymphadenopathy
Slit lamp exam - diffuse, superficial keratitis but no corneal ulceration
- Subepithelial infiltrates likely secondary to adenoviral antigens deposited in corneal stroma^[2]
- These lesions usually regress within 3-6 weeks, but can last for months (and cause vision impairment if within the visual field)^[1]

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Meyer-Rüsenberg B, Loderstädt U, Richard G, Kaulfers P-M, Gesser C. Epidemic Keratoconjunctivitis: The Current Situation and Recommendations for Prevention and Treatment. Deutsches Ärzteblatt International. 2011;108(27):475-480. doi:10.3238/arztebl.2011.0475.
↑ Park SJ, Jang YS, Koh TH, Kwon YA, Song SW. Development of EKC after Eximer Laser Photorefractive Surgery and Subsequent Recurrence of EKC-like Keratitis. Korean Journal of Ophthalmology : KJO. 2011;25(6):443-446. doi:10.3341/kjo.2011.25.6.443.