Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions

Labib, Bisant A; Minhas, Bhawanjot K; Chigbu, DeGaulle I

Due to the aforementioned HAdV characteristics and its interactions with host cells, HAdV has demonstrated a high likelihood of evading the immune response leading to infection. Additional research on its many modes of transmission contributes to the highly contagious nature of HAdV and dissemination into the community. Large-scale epidemics lead to high social and economic burdens, making health education in infected patients an invaluable tool to limit spread. Preventative methods require that patients exercise frequent hand washing with soaps and to keep hands dry, avoiding eye rubbing. Children are to be encouraged to stay home during the infectious phase to limit the spread of disease. Contact with infected towels, soap, bedding, door handles, etc. should also be avoided. Following resolution of the virus, bedding, and towels used by the infected individual should be washed thoroughly and exposed under sunshine (solar ultraviolet radiation) to further ensure elimination of the virus. 27 EKC outbreaks are also commonly spread through ophthalmology clinics, warranting the need to evaluate disinfection procedures for ophthalmic instruments. Methods of spread include tonometry probes, tips of contaminated eye drop bottles, and foreign body removal instruments. A study comparing the efficacy of hydrogen peroxide disinfection versus alcohol swabs determined that there was a more significant reduction in log growth using hydrogen peroxide. The use of disposable prisms is also an option, though many times this method is of limited use due to cost. 28, 29 Because of these unique viral characteristics, ubiquity of HAdV, and its potential for epidemic, several treatment modalities have been investigated to establish an effective treatment protocol. However, at this stage, there is no FDA-approved antiviral treatment for HAdV infections.