Epidemic Keratoconjunctivitis

Aka: Epidemic Keratoconjunctivitis, EKC

1. Epidemiology
   1. Extremely contagious form of Viral Conjunctivitis
   2. Summer outbreaks most common
   3. Virus is shed for 14 days
2. Causes
   1. Adenovirus subtypes
3. Symptoms
   1. Marked Conjunctival Hyperemia
   2. Epiphora (Eye tearing)
   3. Onset in one eye that spreads to the other
   4. Eye Pain (if Corneal involvement)
   5. Blurred Vision
4. Signs
   1. Chemosis (Edema of Conjunctiva around the Cornea)
   2. Superficial viral Corneal infiltrates
5. Complications
   1. Decreased Visual Acuity
      1. Results from Corneal infiltrates (viral particles enter the anterior chamber)
      2. Can last for months
      3. May reduce vision to 20/200
6. Course
   1. Resolution in 2 to 8 weeks
   2. Eye Pain may persist for more than a month
   3. Contagious for 14 days after the start of symptoms in the second eye
7. Management
   1. No specific treatment
   2. Corneal infiltrates with Decreased Visual Acuity:
      1. Topical Steroids
      2. Ophthalmology referral for serial exams
   3. Prevent spread to other patients
      1. Wear gloves and wash hands frequently
      2. Wash equipment between Eye Exams
         1. Wash hand towels in hot water
         2. Clean tonometer carefully
      3. Avoid contamination of ophthalmic solutions