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Epidemic Keratoconjunctivitis Medication

  • Author: Ahmed Bawazeer, MBChB, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Apr 03, 2015
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications. The topical steroids dexamethasone, fluorometholone, prednisolone ophthalmic, and rimexolone 1% are used in the treatment of epidemic keratoconjunctivitis.

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Corticosteroids

Class Summary

Topical corticosteroids are a group of anti-inflammatory agents that cause inhibition of the inflammatory response by potentiation of epinephrine vasoconstriction, stabilization of lysosomal membranes, decrease in macrophage movement, prevention of kinin release, interference with lymphocytes and neutrophil function, and inhibition of prostaglandin synthesis through inhibition of phospholipase enzyme.

Dexamethasone (Maxidex, Ozurdex)

 

Dexamethasone is used for various allergic and inflammatory diseases. It decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.

Fluorometholone (FML, Flarex, FML Forte)

 

This agent suppresses the migration of polymorphonuclear leukocytes and reverses capillary permeability.

Prednisolone ophthalmic (Pred Forte, Omnipred, Pred Mild)

 

Prednisolone ophthalmic decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability.

Rimexolone 1% (Vexol)

 

Rimexolone decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability.

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Ocular Lubricants

Class Summary

These agents are used for symptomatic relief.

Artificial tears (Soothe, Bion Tears, Murine Tears, Systane)

 

Artificial tears act to stabilize and thicken the precorneal tear film and prolong tear film breakup time, which occurs with dry eye states.

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Immunosuppressant agents

Class Summary

Agents with immunosuppressant properties can inhibit autoimmune inflammatory responses.

Tacrolimus ointment (Protopic)

 

Tacrolimus is a treatment option for subepithelial infiltrates in keratoconjunctivitis. Suppresses cellular immunity; mechanism unclear; inhibits T-cell activation by binding to intracellular protein FKBP-12 and complexes with calcineurin-dependent proteins to inhibit calcineurin phosphatase activity.

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Antiseptics, ophthalmic

Class Summary

Antiseptics are broad-spectrum germicidal agents.

Povidone-iodine (Betadine Ophthalmic Prep)

 

Povidone-iodine is an antibacterial agent with broad antibacterial and antiviral activity. No bacteria are known to be resistant to povidone-iodine. Povidone-iodine is far less expensive and less toxic than agents currently used to prevent conjunctivitis. Used to reduce the duration of conjunctivitis.

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Contributor Information and Disclosures
Author

Ahmed Bawazeer, MBChB, FRCSC  Professor and Chairman of Ophthalmology, Department of Ophthalmology, Division of Uveitis and Cornea, King Abdulaziz University, Saudi Arabia

Ahmed Bawazeer, MBChB, FRCSC is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

William G Hodge, MD, PhD, FRCSC Professor and Chair, Ophthalmologist in Chief, Ivey Eye Institute, Schulich School of Medicine and Dentistry, University of Western Ontario

William G Hodge, MD, PhD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, Canadian Medical Association, Canadian Ophthalmological Society, Ontario Medical Association, Quebec Medical Association, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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. 2001 Dec. 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. 2002 May. 109(5):845-50. [Medline].

  3. Yamazaki ES, Ferraz CA, Hazarbassanov RM, Allemann N, Campos M. Phototherapeutic keratectomy for the treatment of corneal opacities after epidemic keratoconjunctivitis. Am J Ophthalmol. 2011 Jan. 151(1):35-43.e1. [Medline].

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

  5. Levinger E, Trivizki O, Shachar Y, Levinger S, Verssano D. Topical 0.03% tacrolimus for subepithelial infiltrates secondary to adenoviral keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol. 2014 May. 252(5):811-6. [Medline].

  6. Özen Tunay Z, Ozdemir O, Petricli IS. Povidone iodine in the treatment of adenoviral conjunctivitis in infants. Cutan Ocul Toxicol. 2015 Mar. 34(1):12-5. [Medline].

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Follicular conjunctivitis and subconjunctival hemorrhage.
Symblepharon secondary to epidemic keratoconjunctivitis.
 
 
 
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