What Is Keratoconjunctivitis?
Epidemic keratoconjunctivitis (EKC) is an infectious eye disease caused by a viral infection. Its clinical features are rapid onset, conjunctival hyperemia, edema, more follicles, and spotted infiltration of corneal epithelial cells. The causative agent of this disease is adenovirus. Adenovirus type is the most common and often causes outbreaks.
Basic Information
- English name
- epidemic keratoconjunctivitis
- English alias
- BKC
- Visiting department
- Ophthalmology
- Common locations
- eye
- Common causes
- Adenovirus
- Common symptoms
- Conjunctival congestion, edema, foreign body sensation, burning sensation, fear of light, tears, and mild visual impairment.
- Contagious
- Have
- way for spreading
- Contact spread
Causes of epidemic keratoconjunctivitis
- The disease is usually acquired by adenovirus infection or contact infection.
Clinical manifestations of epidemic keratoconjunctivitis
- Epidemic keratoconjunctivitis
- The incubation period is 5-12 days, mostly 8 days. Both eyes usually develop, starting with one eye, and the other eye is affected after 2 to 7 days. The patient has a foreign body sensation, burning sensation, fear of light, tears, and mild visual impairment.
- (1) Systemic manifestations include fever, sore throat, diarrhea, and pneumonia. This condition is more common in children and less common in adults. Swelling and tenderness in the ears and submandibular lymph nodes are more common.
- (2) A large number of follicles are formed in conjunctival lesions . Conjunctival congestion and edema are obvious, and false membranes are formed in the lower conjunctiva. Watery secretions. The upper eyelid conjunctiva has a bit of bleeding. Sometimes the palpebral conjunctiva can have flat scars or blepharoplasty.
- (3) Keratopathy Peripheral superficial keratitis; Central superficial keratitis; Subepithelial infiltration; Multiple corneal epithelial erosions.
- 2. Pharyngeal-conjunctival fever (PCF)
- The incubation period is 5 to 6 days, which usually develops in both eyes, and may occur sequentially or simultaneously. Typical manifestations are the triad of conjunctivitis, fever, and pharyngitis.
Keratoconjunctivitis examination
- Virus isolation
- The virus was isolated from the patient's conjunctival sac. The positive rate was highest at 8 days, followed by 6-10 days, and negative after 11 days.
- 2. Serological examination
- The neutralizing antibody titer in the recovery phase was more than 4 times higher than that in the acute phase.
- 3. Immunofluorescence technology
- That is, at the peak of the disease (about 1 week), a conjunctival epithelium scrape or a secretion smear was taken and labeled with fluorescein-labeled antibodies. Viral antigens were found in infected epithelial cells in almost all cases.
Diagnosis of epidemic keratoconjunctivitis
- The disease is not difficult to diagnose during the epidemic. In this period, patients with bulbar conjunctival congestion and upper eyelid swelling should be considered first. The final diagnosis also depends on the results of virus isolation and serology.
Treatment of epidemic keratoconjunctivitis
- Epidemic keratoconjunctivitis is a self-limiting disease. In the course of its course, with the establishment of immune mechanisms, it can heal quickly.
- Antiviral drugs
- Commonly used drugs are:
- (1) Morpholine diamidine (ABOB) uses 10% to 15% solution and eye ointment 4 to 10 times per day. Cooperate with oral treatment if necessary. ABOB generally has no special side effects, and multiple epithelial erosions can occur when the high-concentration solution is used excessively in the eye.
- (2) Iodoside (IDU) 0.1% IDU solution or 0.25% eye ointment, 4 to 8 times per day.
- (3) Make eye drops 4 to 8 times per day with a 1.25% povidone (PVP) solution or 0.5% eye ointment .
- 2. Antibiotic drugs
- Commonly used drugs are gentamicin, kanamycin solution or eye ointment. Suspension should be avoided as far as possible to reduce local irritation.
- 3. Vasoconstriction drugs
- When the congestion is heavy, 0.1% epinephrine can be used to dilute the eye 20 times with saline, which can reduce eye congestion and improve symptoms. Generally, it should not be used for a long time, and the eye drops 3 to 5 times per day for 1 week.
- 4. Glucocorticoids
- (1) Conjunctivitis The commonly used drugs are 0.1% flumilone (FML) and 0.02% dexamethasone solution, 4 to 6 times per day, and eye drops with cortisone ointment at night.
- (2) After 2 weeks of keratitis , when the conjunctival inflammation subsides, those who do not have keratitis should stop using it immediately. If subepithelial infiltration should be continued, patients with less severe disease can use 0.05% flumilone or 0.02% dexamethasone 4-6 times / day eye drops; heavier patients can use 0.1% flumilone or 0.05% ~ 0.1 % Dexamethasone 6 to 8 times per day eye drop, if necessary, combined with subconjunctival injection of 2mg of dexamethasone, once a day or every other day, do not stop the drug immediately to prevent recurrence.
- 5. Other drugs
- Preservative-free artificial tears, glutathione, or 1% chondroitin sulfate sodium eye drops can be used; oral vitamin B 2 , vitamin B 6 , indomethacin, or butapine. For those with extensive epithelial erosion, use eye drops and ointments with less irritation as much as possible. If you can use growth factors (EGF, bFGF) or your own serum eye drops, better results will be achieved.