Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions

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

d not yield a statistically significant reduction when compared to control groups, whereas prednisolone did. This study suggests that NSAIDs are not likely to have any clinically significant antiviral effects. 73 It is important to note that even though NSAIDs offer a higher safety profile with long-term use in comparison to topical corticosteroids, they do not seem to be useful in cases of HAdV-associated conjunctivitis. They are also not without complication and associated with risk of corneal melt. 74 Pseudomembranes are marked by fibrin rich exudation lacking blood or lymphatic vessels, while true membranes are formed by coalescence of the exudation over the substantia propria of mucous membranes; both are common in adenoviral keratoconjunctivitis and may hemorrhage upon removal. 1 Histopathological studies indicate the presence of fibrin, neutrophils, macrophages, effector lymphocytes, and activated dendritic cells in these films. 1 Because pseudomembrane formation can present in severe cases of adenoviral keratoconjunctivitis in the setting of an intense inflammatory response (Figure 2 ), inoffice removal of the pseudomembrane could be beneficial in preventing further complications of conjunctival fibrosis and long-term sequelae. Additionally, pseudomembrane manifestation along with SEIs necessitates the need for topical anti-inflammatory management.