Adenoviral keratoconjunctivitis
Common and highly contagious viral infection of the eye
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Through Fever, Pathogen transmission and Antibiotic
It is commonly caused by types 8 and 37 adenoviruses. Transmission is by contaminated eye examination instruments and eye solutions, touching eyes of infected people, inadequately chlorinated swimming pools, or other contaminated objects. The incubation period is around five to 10 days.
Usually, the condition resolves after 7 to 10 days without treatment. Cold compresses and artificial tears may help. Corneal scarring occurs in up to half of cases and the blurred vision may continue for a long time in some people. The virus may remain in the eye for two to three years after recovering.
It is a common cause of a red eye and tends to occur in large numbers of people at the same time. Adults tend to be affected more frequently than children.
Signs and symptoms
Adenoviral keratoconjunctivitis typically presents as a conjunctivitis with a sudden onset of red eye, watery discharge, and a feeling that something is in the eye. Photophobia develops with blurred vision and lymphadenopathy by the ear nearest the affected eye. It is typically associated with a pharyngitis and rhinitis, mainly in adults. A type of adenoviral keratoconjunctivitis in very young children can present with a high fever, sore throat, ear infection, vomiting and diarrhea.
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Diagnosis
The diagnosis of adenoviral keratoconjunctivitis is done using cell culture (with immunofluorescence staining) and PCR.
Differential diagnosis
It may appear similar to herpes simplex type I, Acanthamoeba, and fungal infection.
Prevention
Adequate infection control measures should be followed as prevention and to reduce epidemic AKC outbreaks.
Treatment
Treatment of adenoviral conjunctivitis is supportive, usually involving lubricating eye drops and cold compresses. In cases of severe itching, antihistamines may help alleviate symptoms. Antibiotics are rarely prescribed to prevent secondary infections. There is clinical evidence that topical ganciclovir is effective against at least adenovirus serotype 8, thus compelling many clinicians to prescribe this agent off-label for compelling cases of epidemic keratoconjunctivitis (EKC), particularly when corneal lesions are noted.
Epidemiology
Globally it is the most common cause of a red eye and tends to occur in large numbers of people at the same time. Adults tend to be affected more frequently than children.