Keratoconjunctivitis

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Background

Keratoconjunctivitis is concurrent inflammation of both the cornea and conjunctiva.

Multiple etiologies:

  • Atopic keratoconjunctivitis: common in patients with atopy(ie: eczema, allergies, asthma, rhinitis)
  • Epidemic keratoconjunctivitis: highly contagious viral(Adenovirus) conjunctivitis, associated with watery discharge
  • Keratoconjunctivitis photoelectrica(subtype of UV Keratitis)
  • Keratoconjunctivitis sicca: associated with autoimmune disorders such as Sjogren's Syndrome, Sarcoidosis, Rheumatoid arthritis, and Schleroderma

Clinical Features

intense itching excessive tearing burning sensation clear mucus discharge conjunctival erythema/hyperemia blurred vision photophobia foreign body sensation Thickened, scaly, indurated eyelids are characteristic of Atopic Keratoconjunctivitis Chronic inflammation may eventually lead to vision loss

Diagnosis

Diagnosis is usually achieved based on clinical history and presentation alone.

Management

Based on likely etiology and severity:

Severity:

  • Mild: basic eye care(resist itching, cold compress, artificial tears), antihistamines, mast cell stabilizers
  • Moderate/Severe: should be referred to Ophthalmologist

Etiology:

  • Atopic keratoconjunctivitis: chronic management should be determined by Ophthalmologist
  • Epidemic keratoconjunctivitis: usually self-resolving
  • Keratoconjunctivitis photoelectrica: eye rest and proper eye protection
  • Keratoconjunctivitis sicca: chronic management should be determined by Ophthalmologist