Viral keratocounjunctivitis also known as Epidemic Keratoconjunctivitis (EKC) is a contagious eye infection, though cornea is involved conjunctiva is far commonly involved but due to increased use of local steroids as a self medication corneal involvement is becomming commoner now days.
It is highly contagious and can last as long as a month.
It occurs mostly in places of close human contact, such as schools, hospitals and office environments.
Causes and spread of Epidemic Keratoconjunctivitis
EKC is caused by a virus called adenovirus. Adenovirus is the commonest virus infecting our upper and lower respiratory tract coursing common cold, sore throat, bronchitis etc.
The most common way it develops is by direct contact with tears or other fluids from infected eyes. Close human contact among members of households, offices, in jam packed local trains etc. spreads infection.
Symptoms of Epidemic Keratoconjunctivitis
People with EKC usually complain of a sudden onset of eye redness, irritation, soreness, light sensitivity and excessive tearing. Some people with the infection say that it feels like a piece of sand or foreign body is in the eye. Both the eye and eyelid can become swollen. The viral infection usually involves one eye first, and then eventually infects the other eye. People with EKC may have significantly blurred vision for several days.
Diagnosis of Epidemic Keratoconjunctivitis
The patients reach to an eye doctor in the initial phase of the epidemic only. The initial part of the disease (only conjunctivitis) is congestion tearing photophobia swelling of the lids and mild to moderate pain. Blurring of vision occurs in some patient when cornea gets involved (kertocounjuctivitis)causing white punctate sub epithelial infiltrates called superficial punctate keratitis(spk)Which may stay for very long period of time and in very rare cases cause permanent scarring.
Treatment of Epidemic Keratoconjunctivitis
Since antibiotic medicines are not effective in treating EKC, treatment focuses on alleviating unwanted symptoms. In mild cases, doctors prescribe cold compresses, and vasoconstrictors. Frequent eye washes with clean water also help to decrease viral load and control infection
Dos and don’t s in the treatment of ekc
1 Dos
1. As far as possible avoid unnecessary public contact by travelling attaining school, office, etc at list in infective phase (when eyes are watering)
2. Keep your napkin, towel, soap etc isolated to avoid contact spread at home.
3. Use dark goggles they are helpful against photophobia and help in spreading droplet infection
4. Consult your ophthalmologist before using any eye drops
Don’ts
3. Avoid self medication some times it may end up in loosing your vision
4. Avoid steroid local drops (the drops having contents like dexamithazone, prednisolone betamethazone etc as a single drug or in combination
Following are the complications of using local steroids without consulting ophthalmologist
1. Simple conjunctivitis becomes keratocounjunctivitis that is superficial punctate keratitis (spk) develop and causing blurring of vision for long period of time (some times 6 months to 1 year)
2. Spk goes with steroids but reappears as soon as steroid are tapered
3. Sub counjunctival hemorrhage are commoner with use of local steroids the red eyes
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