Keratoconjunctivitis

Background

• Defined as concurrent inflammation of both the cornea and conjunctiva.
• Multiple etiologies:
  • Atopic keratoconjunctivitis: common in patients with atopy(ie: eczema, allergies, asthma, rhinitis)
  • Epidemic keratoconjunctivitis: highly contagious viral(Adenovirus) conjunctivitis, associated with watery discharge
  • Keratoconjunctivitis photoelectrica(subtype of UV Keratitis)
  • Keratoconjunctivitis sicca: associated with autoimmune disorders such as Sjogren's Syndrome, Sarcoidosis, Rheumatoid arthritis, and Schleroderma

Clinical Features

• intense itching
• excessive tearing
• burning sensation
• clear mucus discharge
• conjunctival erythema/hyperemia
• blurred vision
• photophobia
• foreign body sensation
• Thickened, scaly, indurated eyelids are characteristic of Atopic Keratoconjunctivitis
• Chronic inflammation may eventually lead to vision loss

Evaluation

• Generally clinical

Management

Based on likely etiology and severity:

Severity:

• Mild: basic eye care(resist itching, cold compress, artificial tears), antihistamines, mast cell stabilizers
• Moderate/Severe: should be referred to Ophthalmologist

Etiology:

• Atopic keratoconjunctivitis: chronic management should be determined by Ophthalmologist
• Epidemic keratoconjunctivitis: usually self-resolving
• Keratoconjunctivitis photoelectrica: eye rest and proper eye protection
• Keratoconjunctivitis sicca: chronic management should be determined by Ophthalmologist