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    When corneas go viral: Epidemic keratoconjunctivitis edition

    This highly contagious virus can be frustrating and difficult to treat

    The possibility that a given garden-variety case of viral conjunctivitis is a burgeoning epidemic keratoconjunctivitis (EKC) is enough to intimidate any physician.

    The term “pink eye” is a broad term often used to describe conjunctivitis caused by both bacteria and a virus; however, in this article we will refer exclusively to viral conjunctivitis. Its contagious nature universally strikes dread into both practitioners and patients alike.

    It is with good reason that we approach pink eye with trepidation—it is estimated that up to 45 percent of people in an EKC patient’s close surroundings may become infected.1 In this article we will discuss transmission, diagnosis, ocular and corneal manifestations as well as current and future thoughts regarding treatment.

    Virus transmission

    Since 1953, seven species (named A through G) and 54 serotypes have been named  for the systemic adenovirus.2 As a whole, these serotypes are known to cause infections ranging from gastroenteritis to respiratory tract infections to several varieties of viral conjunctivitis.

    At least 19 out of the 54 serotypes are known to cause eye infection—those most commonly associated with causing EKC are adenovirus 8, 19, and 37.1 Interestingly, less than 5 percent of the general U.S. population has immunity to type 8 antibodies, so our fears of low natural immunity seem to be founded because almost every individual is considered susceptible.1

    EKC’s incubation period is between 2 and 14 days, during which time patients may not be aware they are carrying the infection. Patients may remain infectious for over 14 days after the symptoms begin.1,2 It is during the symptomatic period when “viral shedding” occurs—manifested by the classic watery and crusty eyes. Infectious cell lysis into the ocular fluids and onto unsuspecting objects and individuals is usually transmitted via direct contact with the eyes by fingers or any other “carrier” object.2

    Related: Does the cornea have 5 or 6 layers?

    Marta C. Fabrykowski, OD, FAAO
    Dr. Fabrykowski received her Doctor of Optometry in 2011 from The Ohio State University College of Optometry. She completed a residency ...

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