eMedicine Specialties > Ophthalmology > Conjunctiva

Keratoconjunctivitis, Epidemic: Follow-up

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

Follow-up

Further Outpatient Care

  • Depending on the severity of the signs and symptoms, patients should be followed up in several days to weeks.
  • Any patient on topical corticosteroids should be observed routinely to monitor for adverse effects, including elevated intraocular pressure and cataract formation.

Deterrence/Prevention

  • Patients should be very careful not to spread the infection by not touching others, by not sharing tissues, towels, or handkerchiefs, and by washing their hands frequently as long as the eye is red.
  • Eye care professionals need to be extremely cautious regarding spreading of this infection to themselves or other patients. They should wash their hands immediately after examining any patient with a red eye. Anything the patient might have touched (especially the examination chair, slit lamp, and occluder) should be disinfected by office personnel immediately after the patient leaves the room.

Complications

  • Severe decrease in visual acuity secondary to subepithelial corneal opacities
  • Conjunctival scarring and symblepharon

Prognosis

  • EKC is self-limiting and resolves spontaneously within 2-3 weeks.

Patient Education

  • Prevention is the most important aspect of management.
    • Wash your hands before examining any patient.
    • Properly clean and sterilize ophthalmic instruments with hypochlorite solution.
    • Create a "red eye room" to separate red eye patients from others in the waiting room.
    • Patients who are infected should not share towels, pillows, washcloths, or other communal objects.
    • Personnel who are infected should be removed from duty for 2 weeks.
    • Warn other family members about the disease.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education articles Pinkeye and How to Instill Your Eyedrops.

Miscellaneous

Medicolegal Pitfalls

  • Every effort needs to be made not to spread infections from one patient to another patient. A “red eye room” is a very good idea to try and limit potential spread. After any patient with a possible EKC infection is seen, the room needs to be disinfected. Physicians should wash their hands thoroughly after seeing any patient with a red eye. As a routine, they should wash their hands before seeing all patients.
 


More on Keratoconjunctivitis, Epidemic

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

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Further Reading

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Keywords

epidemic keratoconjunctivitis, EKC, pink eye, adenoviral conjunctivitis

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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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