Epidemic Keratoconjunctivitis (EKC)

Epidemic Keratoconjunctivitis (EKC)
SYMPTOMS Tearing | Itch | Discomfort | Blurry vision
SIGNS Pseudomembrane | Subepithelial infiltrates (SEIs) | Conjunctival injection | Follicles | Chemosis |Tearing | Preauricular lymphadenopathy
WORK-UP Thorough history. Slit lamp examination
TREATMENT
Observation | Preservative-free artificial tears | Cool compresses
Topical steroids: Pred Forte 1% 1 gtt OU qid x 1 wk | Lotemax 1 gtt OU qid x 1 wk
If a pseudomembrane is present peel with a cotton-tip applicator or smooth forceps | Consider the use of a betadine (povidone-iodine) wash in early EKC
FOLLOW-UP 1 week during treatment
ADDITIONAL LAB | TESTS The AdenoPlus test can be used to identify adenovirus infections
ETIOLOGY Usually adenovirus
DIFFERENTIAL DX Allergic conjunctivitis | VKC | Dry eye syndrome
NOTES Ask about recent upper respiratory infections or illnesses | EKC is usually self-limited | Patients should take extra care of exposure and hygiene due to the contagious nature of EKC.

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