Adenovirus Infections and Treatment

Approximately 19 out of 40 adenovirus serotypes can cause eye infections. These infections present in two clinical forms:
✔ Pharyngoconjunctival fever (PCF)
✔ Epidemic keratoconjunctivitis (EKC)

The disease spreads via direct contact or airborne transmission. Diagnosis is primarily clinical, as laboratory and pathological tests have limited use in viral infections.

Pharyngoconjunctival Fever (PCF)

✔ Adenovirus types 3, 4, and 7 are commonly responsible.
✔ Symptoms include:

• Swelling of preauricular lymph nodes
• Watery discharge from the eye
• Redness and swelling of the conjunctiva (chemosis)
  ✔ Corneal involvement is rare, but when present, it may cause foreign body sensation and blurred vision.
  ✔ Symptoms usually resolve within two weeks.

Epidemic Keratoconjunctivitis (EKC)

✔ Adenovirus types 8, 19, and 37 are commonly involved.
✔ More severe than pharyngoconjunctival fever.
✔ The prodromal period (incubation phase before symptoms appear) lasts 6–12 days.
✔ Symptoms include:

• Swollen preauricular lymph nodes
• Excessive watery and mucous discharge
• Severe conjunctival redness and swelling
• Subconjunctival hemorrhages (bleeding under the conjunctiva)
• Formation of pseudomembranes or true membranes (causing adhesion between the conjunctiva and eyelid)
  ✔ By days 6–13, corneal epithelial involvement may cause foreign body sensation and reduced vision.
  ✔ By day 14, 25–50% of cases develop subepithelial corneal opacities, leading to vision loss and halos around lights.
  ✔ The disease typically resolves within 7–21 days.

Treatment

✔ The goal is to relieve symptoms while the immune system fights the infection.
✔ Supportive treatments include:

• Cold compresses to reduce inflammation.
• Vasoconstrictive agents to minimize redness.
• Artificial tears to alleviate dryness.
• Topical corticosteroids in cases of severe inflammation or corneal involvement.