Epidemic Keratoconjunctivitis (EKC) Treatment & Management

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

Approach Considerations

Supportive management of epidemic keratoconjunctivitis includes the following:

  • Artificial tears

  • Cold compresses

  • Cycloplegic agents for severe photophobia

  • Topical corticosteroids

  • Topical agents that have antiviral activity

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.

Surgery is extremely rare and reserved for severe cases with cicatricial conjunctivitis secondary to symblepharon.

If surgery is necessary, it is mainly in the form of fornix reconstruction and entropion repair.

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Corticosteroid, Antiviral, and Immunosuppressive Therapies

Use topical corticosteroid therapy for severe membranous conjunctivitis or a marked reduction in visual acuity from late subepithelial opacities.

Taper this treatment slowly over a period of weeks to months to avoid recurrence of the corneal opacities.

Research has been ongoing for topical agents that have antiviral activity. Cidofovir has been shown to reduce the viral replication cycle and also to be effective as a prophylactic agent. Cidofovir may prove to be one of the most useful topical antiviral agents in the treatment of and prophylaxis for epidemic keratoconjunctivitis (EKC), which constitutes a professional hazard for all eye care professionals. [1, 2]

Topical 0.03% tacrolimus is a treatment option for subepithelial infiltrates. [5]

Povidone iodine can be used to reduce the duration of conjunctivitis. [6]

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Prevention of Epidemic Keratoconjunctivitis

To avoiding spreading epidemic keratoconjunctivitis (EKC), patients should be very careful not to touch others and not to share tissues, towels, or handkerchiefs and to wash 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.

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.

In summary, prevention measures include the following:

  • 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.

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