eMedicine Specialties > Ophthalmology > Conjunctiva

Keratoconjunctivitis, Epidemic: Differential Diagnoses & Workup

Author: Ahmed Bawazeer, MBChB, FRCS(C), Department of Ophthalmology, Division of Uveitis and Cornea, Assistant Professor, King Abdulaziz University, Saudi Arabia
Coauthor(s): William Hodge, MD, Fellowship Director, Assistant Professor, Department of Ophthalmology, University of Ottawa Eye Institute, Canada
Contributor Information and Disclosures

Updated: Jan 7, 2008

Differential Diagnoses

Conjunctivitis, Acute Hemorrhagic
Corneal Abrasion
Conjunctivitis, Allergic
Herpes Simplex
Conjunctivitis, Bacterial
Onchocerciasis
Conjunctivitis, Viral
Trachoma
Contact Lens Complications

Other Problems to Be Considered

Differential diagnosis of acute follicular conjunctivitis includes the following:

Epidemic keratoconjunctivitis
Pharyngoconjunctival fever
Acute trachoma
Acute inclusion conjunctivitis
Primary herpes simplex conjunctivitis
Acute hemorrhagic conjunctivitis
Infectious mononucleosis
Neonatal inclusion conjunctivitis

Differential diagnosis of subepithelial corneal opacities includes the following:

Epidemic keratoconjunctivitis
Herpes simplex infection
Herpes zoster infection
Infectious mononucleosis
Epstein-Barr virus infection
Dimmer keratitis
Brucellosis

Workup

Laboratory Studies

  • A diagnosis is routinely based on the characteristic clinical features.
  • A simple way to diagnose EKC is by conjunctival cytology with Giemsa stain to look for intranuclear inclusions and lymphocytes.
  • To confirm the diagnosis, viral culture is the criterion standard. Use a human epithelial cell line and a Chlamydia transport media.
  • Other available diagnostic methods include fluorescent antibody techniques, Adenoclone or enzyme immune assay, complement fixation, and polymerase chain reaction (PCR).

More on Keratoconjunctivitis, Epidemic

Overview: Keratoconjunctivitis, Epidemic
Differential Diagnoses & Workup: Keratoconjunctivitis, Epidemic
Treatment & Medication: Keratoconjunctivitis, Epidemic
Follow-up: Keratoconjunctivitis, Epidemic
Multimedia: Keratoconjunctivitis, Epidemic
References

References

  1. Romanowski EG, Yates KA, Gordon YJ. Antiviral prophylaxis with twice daily topical cidofovir protects against challenge in the adenovirus type 5/New Zealand rabbit ocular model. Antiviral Res. Dec 2001;52(3):275-80. [Medline].

  2. Hillenkamp J, Reinhard T, Ross RS, Bohringer D, Cartsburg O, Roggendorf M, et al. The effects of cidofovir 1% with and without cyclosporin a 1% as a topical treatment of acute adenoviral keratoconjunctivitis: a controlled clinical pilot study. Ophthalmology. May 2002;109(5):845-50. [Medline].

  3. Kaufman HE, Barron BA, McDonald MB. Nonherpetic viral infections. Cornea. 1998;303-6.

  4. Krashmer JH, Mannis MJ, Holland E. Conjunctivitis: an overview and classification, viral conjunctivitis. Cornea. 2005;601-612, 629-634.

  5. Leibowitz HM, Waring GO. Superficial punctate keratopathy. In: Clinical Disorders: Clinical Diagnosis and Management. 1998:445-7.

  6. Romanowski EG, Gordon YJ, Araullo-Cruz T, Yates KA, Kinchington PR. The antiviral resistance and replication of cidofovir-resistant adenovirus variants in the New Zealand White rabbit ocular model. Invest Ophthalmol Vis Sci. Jul 2001;42(8):1812-5. [Medline].

  7. Sambursky R, Tauber S, Schirra F, Kozich K, Davidson R, Cohen EJ. The RPS adeno detector for diagnosing adenoviral conjunctivitis. Ophthalmology. Oct 2006;113(10):1758-64. [Medline].

  8. Smolin G, Thoft RA. Viral keratitis and conjunctivitis. In: Cornea: Scientific Foundations and Clinical Practice. 2005:359-364.

  9. Sutphin JE, et al. Viral infections. In: Section 8. AAO Basic and Clinical Science Course. 2006:157-160.

  10. Duane's Clinical Ophthalmology on CD-ROM [book on CD-ROM]. 2006. Tasman W, Jaeger EA.

  11. Yanoff M, Duker JS. Disorders of the conjunctiva and limbus. Ophthalmology. 2004;chapter 55:399-401.

Further Reading

Keywords

epidemic keratoconjunctivitis, EKC, pink eye, adenoviral conjunctivitis

Contributor Information and Disclosures

Author

Ahmed Bawazeer, MBChB, FRCS(C), Department of Ophthalmology, Division of Uveitis and Cornea, Assistant Professor, King Abdulaziz University, Saudi Arabia
Ahmed Bawazeer, MBChB, FRCS(C) is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

William Hodge, MD, Fellowship Director, Assistant Professor, Department of Ophthalmology, University of Ottawa Eye Institute, Canada
William Hodge, MD is a member of the following medical societies: American Academy of Ophthalmology, Canadian Medical Association, Canadian Ophthalmological Society, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Anastasios J Kanellopoulos, MD, Assistant Program Director, Clinical Associate Professor, Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York University
Anastasios J Kanellopoulos, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, Eye Bank Association of America, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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