Epidemic keratoconjunctivitis: Difference between revisions
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==Background== | ==Background== | ||
*Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis | *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 | |||
*Caused by adenovirus infection that is highly contagious and tends to occur in epidemics | **Highly contagious and potentially vision-threatening<ref name="Meyer">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.</ref> | ||
**Transmitted via contact with infectious fluids (commonly tear fluid) on hands, tissues, etc<ref name="Meyer" /> | |||
[[File:EKC.png|thumb|Subepithelial infiltrates in EKC]] | |||
==Clinical Features== | ==Clinical Features== | ||
* | *Ranges from subclinical conjunctivitis to severe disease with superimposed bacterial infection and systemic symptoms.<ref name="Meyer" /> | ||
* | *Can be preceded by prodrome of [[cough]], [[fever]], malaise, [[myalgia]]s, [[nausea/vomiting]] | ||
** | *Worsening foreign body sensation (starts near medial canthus and spreads laterally), followed by<ref name="Meyer" />: | ||
** | **Lid swelling | ||
** | **Tearing | ||
**Itching | |||
**Photophobia | |||
**[[Blurred vision]] | |||
**Conjunctival injection | |||
**Papillae of inf palpebral conjunctiva | **Papillae of inf palpebral conjunctiva | ||
**Ipsilateral | **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<ref name="Park">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.</ref> | |||
*Slit | **These lesions usually regress within 3-6 weeks, but can last for months (and cause vision impairment if within the visual field)<ref name="Meyer" /> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Conjunctivitis DDX}} | {{Conjunctivitis DDX}} | ||
== | ==Evaluation== | ||
* | *Clinical diagnosis | ||
==Management== | |||
*Artificial tears | |||
*Cool compresses | *Cool compresses | ||
* | *[[Cycloplegic]]s if photophobia is severe | ||
*Rigorous hand hygiene to prevent transmission | |||
==Disposition== | ==Disposition== | ||
* | *Discharge with rapid ophtho follow-up. | ||
==See Also== | ==See Also== | ||
*[[Conjunctivitis]] | *[[Conjunctivitis]] | ||
== | ==References== | ||
<References/> | |||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:ID]] | [[Category:ID]] |
Revision as of 16:36, 5 October 2019
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
Clinical Features
- 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
Differential Diagnosis
Conjunctivitis Types
Evaluation
- Clinical diagnosis
Management
- Artificial tears
- Cool compresses
- Cycloplegics if photophobia is severe
- Rigorous hand hygiene to prevent transmission
Disposition
- Discharge with rapid ophtho follow-up.
See Also
References
- ↑ 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.