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EKC demonstrating subepithelial infiltrates in the anterior stroma.
Epidemic Keratoconjunctivitis (EKC)

  • The most common cause of "pink eye".
  • Self limiting disease.
  • Clinical features:
    • Very acute and highly infectious external eye infection caused by Adenovirus type 8 and 19.
    • The spectrum of the disease could be from mild and inapparent, to full blown cases.
    • Symptoms:
      • Foreign body sensation, photophobia, conjunctival hyperemic, eyelid stuck together in the morning, eyelid edema and sero-fibrinous discharge
      • Ocular symptoms commonly preceded by systemic symptoms of fever, sore throat and sometimes gastrointestinal disturbances
    • Signs:
      • Acute onset of unilateral, followed by bilateral papillary and follicular reaction
      • Bilateral tender and enlarged preauricular lymph node
      • Diffuse epithelial punctate keratitis end erosions over the central cornea appear during the first or second week of the disease
      • The epithelial lesions gradually coalesce and form coarse spots of subepithelial infiltrates
      • These small-rounded subepithelial opacities may persist for weeks, months or even years
      • The first affected eye usually will suffer from relatively more prominent and prolonged keratitis than the fellow eye
      • Pseudomembrane formation may occur and can be complicated with conjunctival scarring and symblepharon
    • The viruses can be readily spreaded by finger to eye contact, therefore hand washing and proper disinfection of instruments after contact with any patient suspected of having EKC are mandatory.
  • Management:
    • Symptomatic relief with artificial tears and systemic analgesic maybe required.
    • Topical corticosteroids and cycloplegic are useful in patients with marked iritis and central corneal subepithelial infiltrates.

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