Summary about Disease
Keratoconjunctivitis epidemica (EKC) is a highly contagious viral infection affecting the conjunctiva (the membrane lining the eyelid and covering the white part of the eye) and the cornea (the clear front surface of the eye). It's characterized by inflammation, redness, watery discharge, and discomfort in one or both eyes. It's often associated with outbreaks, especially in healthcare settings.
Symptoms
Redness of the eye(s)
Watery discharge
Feeling of a foreign body or grittiness in the eye
Swollen eyelids (edema)
Sensitivity to light (photophobia)
Blurred vision
Small, painful bumps (follicles) on the conjunctiva
Swollen lymph nodes in front of the ear (preauricular lymphadenopathy)
Corneal involvement may cause small, cloudy spots (subepithelial infiltrates) that can affect vision.
Causes
EKC is primarily caused by adenovirus, most commonly serotypes 8, 19, and 37. The virus is spread through direct contact with contaminated surfaces, medical instruments, fingers, or respiratory secretions of infected individuals.
Medicine Used
There is no specific antiviral medication to cure EKC. Treatment focuses on managing symptoms and preventing secondary bacterial infections. Common treatments include:
Artificial tears: To relieve dryness and irritation.
Cold compresses: To reduce swelling and discomfort.
Topical corticosteroids: In severe cases, may be prescribed to reduce inflammation and corneal infiltrates, but should be used cautiously under the supervision of an ophthalmologist due to potential side effects.
Topical antibiotics: May be prescribed to prevent or treat secondary bacterial infections.
Povidone-iodine: Some studies suggest that early treatment with povidone-iodine may reduce the duration and severity of the disease. However, this treatment is not universally accepted and should be discussed with a doctor.
Is Communicable
Yes, EKC is highly contagious. It spreads easily through direct contact with infected individuals, contaminated surfaces, or medical instruments.
Precautions
Frequent handwashing: Wash hands thoroughly and frequently with soap and water, especially after touching your eyes or face.
Avoid touching your eyes: Refrain from rubbing or touching your eyes.
Use separate towels and washcloths: Avoid sharing towels, washcloths, and other personal items.
Disinfect surfaces: Regularly disinfect frequently touched surfaces like doorknobs, countertops, and phones.
Avoid sharing eye makeup: Do not share eye makeup or applicators.
Avoid swimming pools: Avoid swimming in pools if you have EKC, as the virus can spread through the water.
Healthcare settings: Strict adherence to infection control protocols is crucial in healthcare settings to prevent outbreaks.
Stay home: If you have EKC, stay home from work or school to prevent spreading the infection.
How long does an outbreak last?
An individual case of EKC typically lasts for 2 to 4 weeks. However, corneal involvement (subepithelial infiltrates) may persist for months or even years in some cases, affecting vision. Outbreaks can last for extended periods depending on the source and how effectively infection control measures are implemented.
How is it diagnosed?
Diagnosis is primarily based on clinical examination and the characteristic symptoms of EKC. A doctor will examine the eyes, check for swollen lymph nodes, and ask about the patient's medical history. In some cases, viral cultures or PCR testing of conjunctival swabs may be performed to confirm the diagnosis and identify the specific adenovirus serotype involved.
Timeline of Symptoms
Incubation period: 5-12 days
Initial symptoms: Redness, tearing, foreign body sensation, and eyelid swelling typically appear first.
Progression: Symptoms worsen over the first week, with increased redness, discharge, and light sensitivity. Follicles may appear on the conjunctiva.
Corneal involvement: Corneal infiltrates may develop during the second week, causing blurred vision.
Resolution: Symptoms gradually improve over 2-4 weeks, although corneal infiltrates can persist for longer.
Important Considerations
EKC can cause significant discomfort and temporary vision impairment.
Corneal involvement can lead to long-term visual problems in some individuals.
It's essential to consult a doctor for diagnosis and management of EKC.
Strict adherence to hygiene and infection control measures is crucial to prevent the spread of the infection, especially in healthcare settings.
Topical corticosteroids should only be used under the guidance of an ophthalmologist.