Epidemic Keratoconjunctivitis (EKC) Medication

Updated: Jun 04, 2019
  • Author: Ahmed Bawazeer, MBChB, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
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Medication

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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