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Background: In July 2023, an outbreak of viral conjunctivitis swept across India. A knowledge of clinical features and outcome of treatment helps in the management of future outbreaks. AIM: The aim of this study was to report the clinical presentation, treatment, and outcome in patients affected during the outbreak of viral conjunctivitis. Setting and Design: This was a multicentric retrospective case series. MATERIALS AND METHODS: This study reviewed the medical records of all consecutive patients diagnosed with viral conjunctivitis between July 1, 2023, and August 10, 2023, in five centers across India. Results: Of the 793 patients, 525 (66.2%) were male and 268 (33.8%) were female, with a mean age of 34.1 ± 19.0 years. The mean symptom duration was 2.6 ± 2.1 days with bilateral disease in 591 (74.5%) patients. The common ocular signs were conjunctival congestion (793, 100%), lid edema (479, 60.4%), follicles (607, 76.5%), and conjunctival hemorrhages (339, 42.7%). Artificial tears were used in 730 (92.1%) patients, antibiotic eye drops in 661 (83.4%) patients, and steroid eye drops in 428 (54.0%). The time to resolution was the least in patients who had been treated with only artificial tears (4.61 ± 2.24 days) and was maximum in patients who had been treated with topical steroids (6.5 ± 2.51 days), and the difference was significant (P < 0.001). Conclusion: The presence of conjunctival hemorrhages indicated acute hemorrhagic conjunctivitis. Although many patients were treated with topical antibiotics, it was unnecessary, as the shortest resolution time was found in patients who had been received supportive therapy with artificial tear eye drops and not topical antibiotics or steroids.

Amber N Piazza,1 Peter A Downie,1,2 Michael S Lee,3 Bruce R Lindgren,4 Joshua H Olson3 1Medical School, University of Minnesota, Minneapolis, MN, 55455, USA; 2Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, 53226, USA; 3Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, 55455, USA; 4Masonic Cancer Center Biostatistics Core, University of Minnesota, Minneapolis, MN, 55455, USACorrespondence: Joshua H Olson, Department of Ophthalmology and Visual Neurosciences, University of Minnesota, 516 Delaware St SE, MMC 493, Minneapolis, MN, 55455, USA, Tel +1-612-625-4400, Fax +1-612-626-7882, Email olso3675@umn.edBackground: Millions of acute conjunctivitis cases occur in the United States annually. The impact of COVID-19 mitigation practices on viral conjunctivitis incidence within ophthalmology clinics has not been reported. We hypothesized that viral conjunctivitis rates would decrease with implementation of such practices.Methods: A retrospective chart review was conducted at a single academic center’s ophthalmology clinics. Electronic health record data was queried using ICD-10 diagnostic codes to include 649 patients aged 2– 97 with viral, bacterial, or allergic conjunctivitis diagnosed either before (6/1/2018– 5/1/2019) or during (6/1/2020– 5/1/2021) COVID-19 precautions. Conjunctivitis rates per ophthalmology clinic visit were compared using rate-ratio analysis. Logistic regression evaluated the effects of age, sex, and race among those with conjunctivitis.Results: A total of 66,027 ophthalmology clinic visits occurred during the study period. Viral conjunctivitis rates per visit did not significantly change after enacting COVID-19 mitigation strategies, but allergic conjunctivitis rates significantly increased (viral: RR 0.82, 95% CI 0.51 to 1.31, p=0.408; allergic: RR 1.70, 95% CI 1.43 to 2.03, p< 0.001). When controlling for time, younger age (≤ median age 55) (p=0.005) and Caucasian race (p=0.009) were associated with higher viral conjunctivitis frequency.Conclusion: Contrary to trends reported in emergency departments, viral conjunctivitis rates within an ophthalmology clinic did not significantly change after COVID-19 mitigation strategies, though allergic conjunctivitis rates increased. Patients’ avoidance of emergency departments during the pandemic may have contributed. Further investigation is required to explore variation in ophthalmology patient populations and needs based on care setting.Plain Language Summary: A retrospective review included 649 patients with viral, bacterial, or allergic conjunctivitis diagnosed at a single center’s ophthalmology clinics before (6/1/2018– 5/1/2019) or during (6/1/2020– 5/1/2021) COVID-19 precautions. Contrary to emergency department experiences, viral conjunctivitis rates did not significantly change after COVID-19 precautions. However, allergic conjunctivitis rates significantly increased. Conjunctivitis presentation in ophthalmology clinics differed from that reported in emergency departments, warranting further evaluation of variation in patient needs by setting.Keywords: viral conjunctivitis, allergic conjunctivitis, conjunctivitis transmission, COVID-19, COVID-19 precautions

Context: Epidemic keratoconjunctivitis (EKC) is a highly contagious acute conjunctival infection caused by adenovirus. In the 3rd week of July 2023, we observed a surge in the number of patients with EKC in North India. Identifying cases of EKC and controlling its spread are important for preventing larger outbreaks. Aims: The aim of this study was to know the pattern of presentation and laboratory investigation in cases of EKC during a recent outbreak. Materials and Methods: All patients with features of conjunctivitis were examined and investigated. Demographic data and clinical features were recorded. We also collected data on potential exposure through nonstructured interviews. Conjunctival swab and blood sample were collected from two patients for adenovirus qualitative polymerase chain reaction (PCR) and for other conjunctivitis virus panel PCR. Statistical Analysis Used: The characteristics of the EKC cases were described in terms of frequency (n) and percentage (%). The prevalence of EKC was calculated by dividing the number of EKC cases by the total number of patients visiting the clinic during the study period. Results: A total of 387 cases of EKC were reported out of the 2876 patients during the study period of 6 days (prevalence rate = 13.45%). The mean age of the patients was 30.69 ± 20.65 years. All patients complained of redness (n = 387, 100%) and a foreign body sensation (n = 334, 86.3%). The most common sign was conjunctival congestion in 100% of the cases. Four patients had superficial punctate keratitis, three had subepithelial haze, two had pseudomembrane, and one had atypical dacryoadenitis. Of the 387, 291 (75.2%) patients were definitively exposed to acute conjunctivitis within the family or workplace. Adenovirus was detected in both samples of conjunctival swab in real-time PCR; however, blood specimens tested were negative for adenovirus. Conclusions: The recent outbreak of EKC in India is highly contagious and due to adenovirus. The patient should be educated about the contagious nature of EKC and aware that it is easily transmitted by contact.

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To evaluate the frequency of Human adenovirus (HAdV) and its serotypes in keratoconjunctivitis patients who attended the outpatient clinics of Mansoura Ophthalmic Center, Egypt. Conjunctival secretions and corneal scrapings were collected from patients complaining of clinically diagnosed viral keratoconjunctivitis. The molecular method for HAdV detection was performed by polymerase chain reaction (PCR) followed by restriction enzymes (REA) determination of serotypes for hexone gene. HAdV infection was detected in 38% of samples. There were 4 serotypes of Human adenovirus species D (HAdV-D) isolated (4, 8, 37, 3), where HAdV-D8 was the most dominant. Contact with infected patient, follicular conjunctivitis and subepithelial corneal infiltrates are useful features for clinical diagnosis of adenoviral conjunctivitis. HAdV was significant etiological factor of acute follicular conjunctivitis. Accurate diagnosis of adenoviral conjunctivitis is essential for appropriate management, reducing permanent visual impairment and to limit the transmission of the virus within the community. [ABSTRACT FROM AUTHOR]

Purpose: To identify and isolate various viral aetiological agents that cause conjunctivitis among patients with suspected viral conjunctivitis or keratoconjunctivitis who attended the outpatient department (OPD) at a tertiary eye care hospital in Chennai during June 2018 to October 2019 and to correlate the clinical symptomatology with the respective isolated virus. Methods: The study population consisted of 75 patients (age ranging from 6 to 82 years; mean age: 37.3 years) with conjunctivitis of suspected viral aetiology. Samples were obtained using a swab from the inferior palpebral conjunctiva of the affected individual using Dacron swabs placed immediately in a viral transport medium (VTM) and transported to a tertiary virology lab in Chennai, Tamil Nadu in cold chain for screening. All of the above samples were subjected to virus isolation using virus-susceptible cell lines as well as by molecular diagnosis of viruses such as herpes simplex virus, adenovirus, and enterovirus by real-time polymerase chain reaction (PCR). Results: Among the samples obtained, viral aetiology was identified in 58.67% of conjunctivitis samples either by PCR or virus isolation. Among the virus-positive samples, adenovirus, enterovirus, and herpes simplex virus accounted for 40.91%, 31.81%, and 27.27%, respectively. Coexistence of viruses was observed in 18.18% of virus-positive patients. Conclusion: This study identifies adenovirus as the most common viral pathogen that caused conjunctivitis among the study patients followed by enterovirus and herpes simplex virus. More than one viral pathogen was identified in some of the conjunctivitis patients and this showed that the conjunctivitis in the study group was caused by coexistence of various viruses.

Coronavirus disease 2019(COVID-19)is caused by novel coronavirus(SARS-CoV-2), which is widely prevalent around the world and caused global panic. Evidences show that eye transmission is possible, so the ophthalmic medical staff is more likely to be infected. Ocular manifestations of COVID-19 involve conjunctiva, corneal, sclera, anterior chamber, pupils, retina, optic nerve and visual cortex, extraocular muscles and theirs cranial nerves innervation, orbit and lacrimal system. Viral conjunctivitis is the most common ocular manifestation of COVID-19. In order to protect ophthalmic medical staff from infection and to safely carry out clinical work during the epidemic period of COVID-19, this article summarizes the ocular manifestations of COVID-19, including epidemiology, pathophysiology and clinical manifestation.

Conjunctivitis is a common eye infection. Viral, bacterial, and allergic etiologies are the most common. Nurses greatly impact care management of patients with conjunctivitis through assessment, treatment, and in-depth patient education. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the adenovirus genotypes and their epidemiological features between January 2018 and November 2019, in Istanbul, Turkey. Material and Methods: Conjunctival swab samples were obtained from patients who were clinically diagnosed with keratoconjunctivitis. Samples were screened with an Adeno Detector kit (Rapid Pathogen Screening, RPS Inc., South Williamsport, PA). Nucleic acid extraction and amplification were performed with the ADENOVIRUS ELITe MGB® kit in the ELITe In Genius instrument (Elitech Group, Torino, Italy). For subtyping of the strains, sequencing primers targeted the 'Hypervariable Region 7' (HVR-7) of the hexon gene were used. DNA sequence analysis (n:72) was performed with ABI PRISM* 3100 Genetic Analyzer (Applied Biosystems, USA), and subtyping was done by BLAST analysis. Results: The median viral load in the samples (n: 77) was 7 log10 copies/mL (IQR: 4.5-7.4 log10 copies/mL). The clinical finding score was found to be significantly higher in the high viral load group (Adenovirus DNA>6 Log 10 copies/mL) than in the low viral load group (Adenovirus DNA<6 Log 10 copies/mL) (p = 0.031). CONCLUSION: Our study analyzing hAdV strains collected in 2018 and 2019 revealed that genotype 8 is the dominant type (94.0%) in our region. Molecular methods are very useful for future epidemiological studies and the selection of a vaccine strain. [ABSTRACT FROM AUTHOR]

Background: Viral conjunctivitis is an inflammation of the conjunctiva caused by viruses. Interleukin-4 (IL-4) and IL-4R have been reported to associate with the pathogenesis of conjunctivitis; however, the role of IL-4 and IL-4R genetic polymorphisms in conjunctivitis remains unknown. Aim: This study aimed to evaluate the relation between IL-4 gene polymorphisms (rs2243250) and IL-4 gene receptor (rs1805010) with infectious conjunctivitis. Methods: The study was conducted in 92 age-matched volunteers; 50 of viral conjunctivitis patients and 42 of healthy controls. The levels of both IL-4 and total IgE were measured using suitable methods. Genotyping of IL-4 (rs2243250) SNP was performed by Alleles Refractory Mutation Systems PCR (ARMS PCR) method, while the Genotyping of IL-4 receptor (rs1805010) SNP was performed by RFLP PCR method. Results: Our results showed that there is a significant difference in genotype and alleles distributions in IL-4 (rs2243250) SNP between viral conjunctivitis and control. However, no significant difference in genotypes and alleles distribution IL-4 gene receptor (rs1805010) SNP between viral conjunctivitis and control. More ever, there is a significant increase in serum IL-4 and total IgE in viral conjunctivitis than control. Conclusions: the analysis of our results indicates that IL-4 (rs2243250) SNP gene polymorphisms may be an indicator of increasing the incidence of viral conjunctivitis in the Egyptian population. [ABSTRACT FROM AUTHOR]

Importance: Acute infectious conjunctivitis is characterized by ocular redness and discharge, and is a common clinical entity. Evidence-based tools to aid the clinical diagnosis of viral vs bacterial conjunctivitis are lacking and may contribute to overprescribing of topical antibiotics.Objective: To determine the relative prevalence of viral vs bacterial conjunctivitis in adults and children, and to determine which symptoms or signs are suggestive of a viral vs bacterial etiology.Data Sources: A MEDLINE search (January 1946-March 2022) yielded 1891 articles. Included articles were rated using a quality score based on a modified Rational Clinical Examination grading system. Methodological quality levels 1 through 4 required a microbiological reference standard for diagnosis, whereas quality level 5 (the lowest quality) used a clinical reference standard for diagnosis.Study Selection: Consecutive series of patients presenting with acute infectious conjunctivitis and case series of viral or bacterial conjunctivitis alone. Thirty-two studies were included in a meta-analysis to determine prevalence and diagnostic accuracy measures; 27 used a microbiological reference standard for diagnosis and 5 used a clinical reference standard for diagnosis.Results: In studies involving children (5 studies; 881 patients; mean age, 4.7 years [age range, 1 month-18 years]), the prevalence of bacterial conjunctivitis was higher than viral conjunctivitis (71% vs 16%, respectively, P = .01). In the only study of adults (n = 207 patients; mean age, 25.7 years), the prevalence of viral conjunctivitis was higher than bacterial conjunctivitis (78% vs 16%, respectively, P < .001). For the primary analysis of level 1 (n = 6) and level 2 (n = 5) studies (1725 patients total), the clinical findings that best distinguished a viral etiology for conjunctivitis from a bacterial etiology included pharyngitis (sensitivity range, 0.55-0.58; specificity range, 0.89-0.94; positive likelihood ratio [LR] range, 5.4-9.9), preauricular lymphadenopathy (sensitivity range, 0.17-0.31; specificity range, 0.93-0.94; positive LR range, 2.5-5.6), and contact with another person with red eye (sensitivity, 0.18 [95% CI, 0.14-0.22]; specificity, 0.93 [95% CI, 0.90-0.95]; positive LR, 2.5 [95% CI, 1.6-3.7]). Mucopurulent ocular discharge (sensitivity, 0.76 [95% CI, 0.60-0.87); specificity, 0.66 [95% CI, 0.58-0.73]; positive LR, 2.1 [95% CI, 1.7-2.6]) and otitis media (sensitivity, 0.24 [95% CI, 0.20-0.29]; specificity, 0.91 [95% CI, 0.85-0.94]; positive LR, 2.5 [95% CI, 1.5-4.4]) were associated with the presence of bacterial conjunctivitis.Conclusions and Relevance: In this review, bacterial conjunctivitis was more common than viral conjunctivitis in children and viral conjunctivitis was more common than bacterial conjunctivitis in adults, although the prevalence estimates were based on limited evidence. Symptoms and signs associated with a higher likelihood of viral conjunctivitis in adults and children included concomitant pharyngitis, an enlarged preauricular node, and contact with another person with red eye, and signs associated with a higher likelihood of bacterial conjunctivitis included the presence of mucopurulent discharge and otitis media, but no single symptom or sign differentiated the 2 conditions with high certainty. [ABSTRACT FROM AUTHOR]

IntroductionOn February 2, 2020, the head of a visually impaired school notified similar eye symptoms among the students. We investigated the cluster to confirm the diagnosis, identify potential exposures, and propose recommendations.MethodologyWe defined a case as redness/watering/discharge from any eye among the students and staff, January–February 2020. We actively searched for the cases and calculated attack rates. We drew epicurve by date of symptoms onset. We conducted a retrospective cohort study of students and staff. We collected data on potential exposures and calculated Risk Ratio (RR), 95% Confidence Interval (95%CI), and Population Attributable Risk (PAR). We sent a conjunctival swab of the three cases for microbiological analysis.ResultsWe diagnosed the cases as acute conjunctivitis and identified 39 (76%) cases among 51 individuals. All the 39 cases reported watering and redness; 28 (72%) and 12 (31%) reported eye pain and discharge, respectively. The median age of the case was 11 years (range: 6–48 years). The attack rate didn't differ significantly between males [77% (20/26)] and females [76% (19/25), p = 0.9]. The attack rate was higher among the students [86%, (38/44)] than staffs [14%, (1/7), p =

Purpose To evaluate the ocular surface properties in epidemic keratoconjunctivitis (EKC) patients during healing process, and to detect the damage on conjunctival goblet cells. Methods Bilateral EKC patients confirmed with polymerase chain reaction (PCR) testing were included. Firstly (Group 1) and secondly (Group 2) affected eyes were compared. Ocular surface parameters were performed at the first visit and first month. Results The study included 34 eyes of 17 patients. The mean age was 44.54 ± 16.80 (21–70) years (FM/M 20/14). The ocular findings in Groups 1 and 2 were not significant. For Groups 1 and 2, OSDI was 53.53 ± 23.01 and 35.90 ± 22.19 (p 0.03), tear osmolarity was 309.12 ± 19.38 and 297.47 ± 8.27 mOsm/µL (p 0.029), OSSS was 1.00 ± 0.79 and 0.18 ± 0.39 (p 0.001), T-BUT was 3.59 ± 2.29 and 6.00 ± 1.83 s (p 0.002), and Schirmer's 1 test was 10.94 ± 8.42 and 16.76 ± 9.05 mm (p 0.061), respectively. In Groups 1 and 2, the IC was Grade (G) 0 in 23.5% and 17.6%, G1 in 35.3% and 41.2%, and G2 in 41.2% and 41.2%, respectively. The ocular surface properties were worse in Group 1 than Group 2, and the difference was significant except for Schirmer's 1 test and IC. Conclusions Dry eye disorder is a complication of EKC and may cause a significant decrease in quality of life. [ABSTRACT FROM AUTHOR]

Infection mediated ocular surface stress responses are activated as early defense mechanisms in response to host cell damage. Integrated stress responses initiate the host response to different types of infections and modulate the transcription of key genes and translation of proteins. The crosstalk between host and pathogen results in profound alterations in cellular and molecular homeostasis triggering specific stress responses in the infected tissues. The amplitude and variations of such responses are partly responsible for the disease severity and clinical sequelae. Understanding the etiology and pathogenesis of ocular infections is important for early diagnosis and effective treatment. This review considers the molecular status of infection mediated ocular surface stress responses which may shed light on the importance of the host stress-signaling pathways. In this review, we collated literature on the molecular studies of all ocular surface infections and summarize the results from such studies systematically. Identification of important mediators involved in the crosstalk between the stress response and activation of diverse signaling molecules in host ocular surface infection may provide novel molecular targets for maintaining the cellular homeostasis during infection. These targets can be then explored and validated for diagnostic and therapeutic purposes. [ABSTRACT FROM AUTHOR]

Objective: Red eye, a frequent cause of presentations to ophthalmology clinics, is an important indicator of ocular inflammation. Although the prognosis is generally good and self-limiting, it is possible to distinguish possible serious conditions and prevent important situations such as blindness, with detailed examination and correct treatment approach. The purpose of this study was to evaluate patients with red eye presenting to the eye diseases clinic in terms of clinical and sociodemographic characteristics. Methods: Diseases causing red eye were classified according to the International Classification of Diseases (ICD 10) coding system. Demographic characteristics such as age and sex and clinical findings were examined. Data were evaluated using number and percentage tests. Results: A total of 2625 patients, 1775 males (67.61%) and 850 females (32.38%), who presented with red eyes, were evaluated. The mean age of the patients was 36.46±18.24 years. The incidence of viral conjunctivitis, the most frequently observed condition in patients presenting due to red eye, was 15.08% (n=396). The most common cause of red eye resulting in decreased vision and increased intraocular pressure (IOP) was acute angle closure glaucoma (AACG). The most common symptom was stinging-burning (70.36%), and the most frequent finding was follicular hyperplasia (74.17%). Five hundred and seventy-one (21.75%) patients who applied to the clinic with red eye had previously applied to a family physician and 289 patients (11.0%) to an emergency physician. Conclusions: Although prognosis is usually good in red eye, and the condition is self-limiting, the detection of serious conditions through a detailed history, examination, and therapeutic approach can be enhanced with early and appropriate intervention. In addition to family physicians and emergency physicians, the first to examine patients with red eye, important morbidities such as blindness can also be prevented by increasing the awareness of ophthalmologists and cooperation between these. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to renew the management of viral epidemic conjunctivitis by introducing a one-time, low-concentration ocular surface povidone-iodine (LOS-pI) wash., Methods: Among the 3,002 patients screened, 1,328 with acute conjunctivitis were categorized into two groups. Group A (664 patients) underwent a 1% betadine wash in addition to the standard treatment protocol (Eye Lubricant + Moxifloxacin 0.5% eyedrops), while Group B (664 patients) followed the standard protocol alone. In cases of membranous conjunctivitis, manual membrane removal was performed. Treatment responses were observed daily for three days, followed by weekly assessments for two additional weeks., Results: Co-infection of adenovirus with enterovirus was found to be the main cause, often accompanied by staphylococcal superinfection. Group A showed complete resolution of conjunctival inflammation, with a remarkable 76.05% of patients experiencing improvement within an average of 2.6±0.51 days, in contrast to Group B's average of 7.5±1.1 days (p <0.05). Additionally, 13% of Group B patients with recalcitrant conjunctivitis significantly recovered following the 1% betadine wash. Complications (subconjunctival hemorrhage: 34.04%, superficial punctate keratitis: 6.02%) were more prevalent in Group B., Discussion: The authors hypothesized that a single wash with betadine is sufficient to reduce disease duration and prevent secondary infections and complications. The core strength of our study lies in its substantial sample size. To our knowledge, no similar previous research has been conducted, on such a larger scale., Conclusion: Viral conjunctivitis brings discomfort, work absenteeism, and financial burden. A single low-concentration betadine wash expedites recovery and reduces complications in acute infective conjunctivitis. This approach significantly enhances patient outcomes and alleviates the socioeconomic impact of the condition., Competing Interests: The authors state no conflict of interest., (© 2024 The Authors.)

To provide a review for general practitioners and medical specialists about the most common eye complaints and ocular manifestations in a COVID-19 patient. Reviewed 50 articles referenced in 4 databases from 20 December 2019 to 16 September 2020. Of the 50 articles reviewed, 26 met the criteria for analysis and were included in the study. Among them were 5 reviews, 6 case series, 7 case reports, 4 cross-sectional studies, 2 systematic reviews, 1 cohort study and 1 correspondence. We found that the prevalence of ocular manifestations in patients during the course of COVID-19 varied between 0.8% and 31.6%, depending on the study design. Symptoms of acute conjunctivitis were the most frequent clinical findings. Acute phase reactants were also correlated to ocular manifestations and the severity of the systemic disease in many reports. Ocular manifestations are not uncommon in COVID-19 patients and have been associated with higher levels of acute phase reactants as well as a higher degree of severity of the systemic disease. We recommend that all physicians consider COVID-19 as a differential diagnosis in the presence of acute conjunctivitis with or without systemic symptoms. [ABSTRACT FROM AUTHOR]

We report a rare case of very late-onset haze triggered by viral conjunctivitis, > 20 years after treatment of moderate myopia with photorefractive keratectomy (PRK), and its successful management.

Abstract Background Acute infectious conjunctivitis is a common condition most frequently caused by viruses or bacteria. Clinical outcome assessments have been used to assess signs and symptoms of bacterial and viral conjunctivitis, but have not been evaluated for content validity. We aimed to develop content-valid patient- (PRO) and observer-reported outcome (ObsRO) instruments to assess symptoms of ocular discomfort associated with viral or bacterial conjunctivitis in adult and pediatric patients. Methods Draft items were developed from a previous review of published studies from 2001 to 2015. Patients and caregivers of patients with a diagnosis of viral or bacterial conjunctivitis within the past 6 months were recruited. Concept elicitation with open-ended questions explored signs and symptoms, followed by cognitive interviewing to assess clarity and relevance of the draft items. Patients aged ≥8 years were interviewed for the PRO; parents/caregivers of children aged 1–10 years were interviewed for the ObsRO. Interviews were conducted in three rounds to allow changes. Concept saturation was documented using a saturation grid. Cognitive interview data were analyzed iteratively and focused on clarity, relevance and inconsistent interpretation of the instrument’s content. Results Overall, 23 patients or parents/caregivers participated (round 1, n = 10; round 2, n = 6; round 3, n = 7). Data saturation was reached by the 16th interview. The most frequent spontaneously reported signs/symptoms were: discharge, red/pink eyes, itchiness, swelling/puffiness, watery eyes, pain, burning and foreign body sensation. Itching, pain/burning/stinging and foreign body sensation were most commonly reported as the top three most bothersome symptoms. Interview results indicated that items on pain, itching and foreign body sensation for the PRO and pain or discomfort for the ObsRO were relevant to the patients’ experience of conjunctivitis and were clear and easy to understand. Conclusions PRO and ObsRO items were found to be clear, relevant and appropriate in assessing key viral and bacterial conjunctivitis symptoms in adult and pediatric patients.

Conjunctivitis is a common condition characterised by inflammation of the conjunctiva and is the most likely diagnosis in a patient with a red eye and discharge. Acute conjunctivitis is usually a self-limiting condition or one that is easily treated with topical ophthalmic preparations in most cases. Viral conjunctivitis is the most common cause of conjunctivitis followed by bacterial conjunctivitis. Purulent discharge and adherence of the eyelids upon awakening are strong indicators of bacterial conjunctivitis, however other similarities in presentation of conjunctivitis often leads to misdiagnoses. Acute viral conjunctivitis is most commonly caused by adenoviruses and allergic conjunctivitis is usually caused by seasonal pollens. Acute viral conjunctivitis is treated symptomatically while the use of topical antibiotics are useful in limiting the duration of conjunctivitis with a bacterial aetiology. Allergic conjunctivitis is also treated symptomatically with topical antihistamine/mast cell stabiliser preparations. Conjunctivitis secondary to sexually transmitted diseases such as chlamydia or gonorrhoea require systemic antimicrobials in addition to topical treatment.

AIM: To evaluate the clinical characteristics of adenoviral keratoconjunctivitis, the management modalities, as well as the incidence of subepithelial corneal infiltrates (SEI). METHODS: Patients with characteristic clinical symptoms and signs, who presented to our clinic within the first week of symptoms and received the diagnosis of adenoviral keratoconjunctivitis between January 2013 and April 2016, were included in the study. A total of 211 patients were included in the study. Patients were evaluated for the incidence of clinical signs, late complications, management preferences, and the effect of diluted povidone-iodine (d-PVP-I) 2%. RESULTS: Patients’ mean age was 33.03±14.76y. We observed an increase in the number of cases according to the years. At presentation and/or early follow-up, the clinical signs were conjunctival hyperemia (100%), conjunctival follicules (79.1%), edema of the eyelids (39.3%), chemosis (16.1%), pseudomembrane formation (16.6%), and corneal epitheliopathy (29.9%). During late follow-up 13.3% patients developed conjunctival subepithelial fibrosis, and 39.8% developed SEI. A significant decrease in the incidence of SEI development was observed in patients who used d-PVP-I 2% (P=0.032; 33.3% vs 45.9%, respectively in patients who received d-PVP-I 2% and who did not). CONCLUSION: Adenoviral keratoconjunctivitis has a tremendous effect on patient’s comfort and abilities in short-term. Additionally, almost half of the patients develop visual problems related to SEI. According to our clinical experience, using d-PVP-I 2% in the first days of adenoviral keratoconjunctivitis might be helpful in reducing the risk of SEI as a complication.

Conjunctivitis is a common eye condition involving inflammation and in some instances infection of the conjunctiva. In the majority of cases it is caused by adenoviruses and, to a lesser extent, bacteria. Conjunctivitis can also occur secondary to Chlamydial and Gonococcal infections and new-born infants can acquire it during the birthing process from infected mothers. Herpes simplex and Herpes zoster are the infective organisms also responsible for conjunctivitis while seasonal pollens are usually the cause for allergic conjunctivitis. Common symptoms and signs are redness, tearing, oedema of the eyelids, sensation of a foreign body and it may be accompanied by itching. Most often a purulent discharge and adherence of eyelids at awakening are indicators of a bacterial infection. Most of the uncomplicated acute cases are self-limiting. There is however a challenge in distinguishing between the various types of conjunctivitis due to the similarity in the symptoms and due to a lack of tests and prediction algorithms, thus antibiotic therapy is often incorrectly initiated. Treatment of acute uncomplicated conjunctivitis caused by adenoviruses and bacteria is mostly symptomatic. Topical eye drops and ointments are preferred to oral agents in the treatment of more severe bacterial and allergic conjunctivitis while oral agents are used in the treatment of conjunctivitis caused by Herpes simplex, Herpes zoster, Chlamydia trachomatis and Neisseria gonorrhoeae.

COVID-19 is a disease first identified in Wuhan City, Hubei Province, China, in December 2019, causes by a SARS-COV-2 virus infection. By 27 October 2020, 43,921,473 confirmed cases were reported worldwide, with 1,166,389 COVID-19 deaths. Conjunctivitis has been reported in adults and pediatric patients with COVID-19. Objective: The aim of this meta-analysis is to estimate the odd Ratio (ORs) of conjunctivitis in patients with COVID-19. Methods: A systematic review and meta-analysis have been performed using the PubMed and Google Scholar literature search. The ORs of conjunctivitis in adults and pediatric patients is the outcome of this meta-analysis. Results: There have been 1041 articles published since the outbreak in December 2019, according to the latest literature. For the meta-analysis, 20 studies with a total of 3383 participants were included. The odds ratio (ORs) of conjunctivitis was 0.01 (95% confidence interval [CI]: 0.00–0.02). No bias has been reported. Conclusion: Conjunctivitis is the most common ocular manifestations reported in adults. This comprehensive meta-analysis quantifies the existing evidence linking conjunctivitis with COVID-19 and highlights the high percentage of heterogeneity that is shown in the current studies. Finally, it offers a single review article which includes all the current articles available for COVID-19 and conjunctivitis in adults and children. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, has had far-reaching implications beyond the respiratory system. Mounting evidence suggests that COVID-19 can impact various organ systems, including the eyes. This study aimed to elucidate the prevalence, characteristics, and clinical implications of ophthalmic manifestations in patients diagnosed with COVID-19., Methods: This retrospective study analyzed data from electronic medical records of adult patients hospitalized with COVID-19 between March 1, 2020, and December 31, 2020, at a large tertiary academic medical center. Ophthalmic manifestations, including conjunctivitis, dry eye symptoms, ocular pain, epiphora, ocular redness, and visual disturbances, were identified and examined for their prevalence, onset, duration, and associations with COVID-19 severity and systemic symptoms., Results: Among 342 patients included in the study, 106 (31.0%) experienced at least one ophthalmic manifestation during their COVID-19 illness. Conjunctivitis was the most common manifestation in 62 patients (18.1%), followed by dry eye symptoms in 38 patients (11.1%), ocular pain/discomfort in 27 patients (7.9%), epiphora in 19 patients (5.6%), ocular redness in 14 patients (4.1%), and visual disturbances in nine patients (2.6%). Ophthalmic manifestations were significantly associated with severe COVID-19 illness (42.9% vs. 26.7%, p = 0.003) and the presence of systemic symptoms such as fever, cough, and dyspnea. The median time of onset was six days, and the median duration was 10 days., Conclusions: Ophthalmic manifestations are prevalent in COVID-19 patients, particularly in those with severe illness and systemic symptoms. The study highlights the importance of recognizing and managing ocular symptoms in affected individuals and underscores the multifaceted nature of COVID-19, necessitating interdisciplinary collaboration for comprehensive patient care., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Patel et al.)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in late 2019 in Wuhan, Hubei Province, China. The virus has now developed into a full-scale global pandemic affecting hundreds of millions of people to date. A majority of cases present with nonspecific acute upper respiratory symptoms. A wide range of systemic symptoms has been reported, with some patients presenting with nonspecific extrapulmonary symptoms. Recently, there has been an increased association of COVID-19-positive patients presenting with ocular symptoms. As an increasing number of patients present with ophthalmic manifestations, recognizing these visual symptoms is of utmost importance. Some patients may present with ocular symptoms as the first indication of COVID-19 infection; quickly isolating and starting treatment can aid in stopping the spread of this novel coronavirus. This review will describe the current epidemiology and pathophysiology of SARS-CoV-2, emphasizing the ophthalmic manifestations and their clinical course progression. Further, we will be reporting on the growing number of rare ocular manifestations that have occurred in some COVID-19-positive patients, along with the route of transmission, specific manifestations, and the treatment methods for both these pulmonary and extrapulmonary symptoms, specifically the ocular manifestations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Patel et al.)

Purpose: To determine whether topical tobramycin 0.3%/dexamethasone 0.1% plus ozonized oil eye drops reduces clinical signs and infectious viral titers of presumed viral conjunctivitis more than tobramycin/dexamethasone eye drops alone. Methods: Prospective, single-blind, randomized, parallel-groups trial. Eighty patients with a clinical diagnosis of presumed viral conjunctivitis were randomizedly divided into two treatment groups: a study group and a control group, 40 for each group. Patients in the study group received topical tobramycin 0.3%/dexamethasone 0.1% eye drops, plus ozonized oil eye drops, both four times daily; patients in the control group received only topical tobramycin 0.3%/dexamethasone eye drops four times daily. The treatment was for seven days in both groups. Swabs were taken from the conjunctival fornix for adenovirus PCR analysis on the day of recruitment and at seven days follow-up. Clinical signs were also recorded on the day of recruitment and at follow-up examination: the main outcomes were conjunctival injection and conjunctival chemosis, graded on a 4-point clinical scale, presence or absence of superficial punctate keratitis and subepithelial corneal infiltrates. Results: No statistically significant difference was reached in adenoviral infection negativization between the two groups, although the study group showed a higher number of PCR negative results at seven days follow-up. PCR real time detected adenoviral infection in 17 of 24 patients on the day of recruitment and it was positive in 4 patients on the seventh day (viral positivity reduction of 76%). In the control group PCR was positive for adenovirus in 18 of 24 patients on the day of recruitment and in 7 patients at seven days follow-up (reduction of 61%). There was statistically significant difference on conjunctival clinical signs between the study and control groups. Significant difference was also found on superficial punctate keratitis resolution between the study and the control group. In the former superficial punctate keratitis was detected in 14 eyes on the first day and in 5 eyes after seven days while in the latter superficial punctate keratitis was found in 124 eyes on the first day and in 6 eyes on the seventh day. No difference was found in subepithelial corneal infiltrates appearance between the two groups. Conclusions: The use of ozonized-oil containing eye drops in combination with topical tobramycin 0.3%/dexamethasone 0.1% eye drops four times daily seems to reduce the signs of conjunctivitis, and the duration of viral infection, although it does not affect the subepithelial corneal infiltrates appearance. [ABSTRACT FROM AUTHOR]

Viral conjunctivitis, mainly caused by Adenovirus, is currently a health problem to be solved. The increase in infection in recent years and the morbidity that can be associated despite treatment, make it an infectious disease whose knowledge and study is essential for the ophthalmologist. An exhaustive bibliographic review of the main articles published was carried out using the keywords: hemorrhagic conjunctivitis, epidemic keratoconjunctivitis, and adenovirus conjunctivitis, with the aim of discussing the main features, the new diagnostic methods, treatments, quitar and possible complications and clinical implications of the epidemic keratoconjunctivitis. Resumen La conjuntivitis viral, principalmente causada por Adenovirus, es actualmente un problema de salud a resolver. El aumento del contagio en los últimos años y la morbilidad que puede asociarse a pesar del tratamiento hacen que se trate de un cuadro infeccioso cuyo conocimiento y estudio es esencial para el oftalmólogo. Se realizó una revisión bibliográfica exhaustiva de los principales artículos publicados utilizando las palabras clave: conjuntivitis hemorrágica, queratoconjuntivitis epidémica y conjuntivitis por adenovirus, con el objetivo de discutir las principales características, los nuevos métodos de diagnósticos, tratamientos y posibles complicaciones e implicaciones clínicas de la queratoconjuntivitis epidémica.

Background: Viral conjunctivitis is commonly caused by adenoviruses, with a rate of up to 40% of all viral causes. Objective: To show prevalence and clinical features of ocular adenoviral infection at Ibn-Alhaitham teaching eye hospital in Baghdad, Iraq. Patients and Method: In this cross-sectional study, eye swab samples were taken from 638 patients with clinically diagnosed infectious conjunctivitis during the period from August 2019 to February 2020. Samples were processed and tested using polymerase chain reaction (PCR) to detect adenoviral infection. Results: Of 638 patients with infectious conjunctivitis attended to the Ibn Al-Haitham teaching ophthalmic hospital in Baghdad, 113 cases (17.7%) were confirmed to having ocular adenoviral infection with the mean age 27±8.4 years and The highest percentage of those affected in the age group 1-10-year-old (31.9%). Sixty-three were male (55.8%) and 50 were females (44.2%). non-statistically significant difference between unilateral & bilateral involvement. Of total 113 patients with ocular adenoviral infection, 50 (44.2%) patients experienced flu-like illness during or before their ocular complaint, 85 (75.2%), 28 (24.8%) showed conjunctival follicular reaction and conjunctival membrane formation respectively. Only four (3.5%) patients showed no corneal changes during their ocular infection, 39 (34.5%) patients showed mild punctate epithelial keratitis, 54 (47.8%) patients showed significant punctate epithelial keratitis and 16 (14.2 %) patients showed anterior stromal infiltrate. 64 (56.6%) patients developed lymphadenopathy. During follow up, 13 (11.5%) of patients fully recovered within less than 14 days, 69 (61%) patients recovered in 2-4 weeks whereas 31 (27.4%) patients took longer than 4 weeks for a full recovery. Conclusion: Results have demonstrated that adenoviruses are common causative agents for infectious conjunctivitis. PCR revealed to be more sensitive and accurate for detecting adenoviral ocular infection [ABSTRACT FROM AUTHOR]

Purpose: To find the clinical profile and prevalence of conjunctivitis and other ocular manifestations in mild COVID-19 positive patients in a nodal COVID-19 hospital.Methods: A retrospective cross-sectional, single-center study conducted in 127 mild cases of COVID-19 positive patients admitted between 27th March and 19th April 2020 in a tertiary care COVID-19 hospital in north India. From the hospital records, demographic data is collected. Ocular history and ocular examinations were done by face-to-face survey during ward rounds.Results: A total of 127 patients were included in the study with a median age of 38.8 years. Forty-eight (37.80%) patients had upper respiratory tract symptoms, 20 (15.75%) patients had systemic illness, 18 (14.17%) patients were using spectacles, and 50 (39.37%) patients had history of hand-eye contact. Out of 12 (9.45%) patients who had ocular complaints, 11 (8.66%) had ocular manifestation after admission. Among 11 patients, eight (6.29%) had conjunctival congestion. Three (3/8) patients had developed conjunctival congestion even before the manifestation of definite COVID-19 symptoms. Five patients (5/8) patients had no other associated ocular symptoms other than congestion. Six patients (6/8) had symptoms of upper respiratory tract infection.Conclusion: Mild conjunctivitis manifesting as conjunctival congestion is common and is one of the major ocular manifestations in COVID-19 positive patients even with milder disease. [ABSTRACT FROM AUTHOR]

The diagnosis of acute infectious conjunctivitis can be difficult. Clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. Also, discrimination between viral or bacterial origins of infectious conjunctivitis based on historical, nonspecific, clinical signs and symptoms contributes to a high rate of misdiagnosis and overuse of antibiotic treatment. Therefore, in order to effectively treat acute infectious conjunctivitis, physicians must be aware of the clinical signs and symptoms and available diagnostic tests that can provide a more accurate differential diagnosis. [ABSTRACT FROM AUTHOR]

Importance: To update the literature on the current trends of viral conjunctivitis infections in Sydney, Australia.Background: To find correlations between viral and patient characteristics on disease outcomes and to assess the rates of antibiotic and steroid use in patients with viral conjunctivitis prior to and after assessment by ophthalmology trainees.Design: Retrospective single-centre case series.Participants: 368 eyes of 224 patients diagnosed with viral conjunctivitis at the Sydney Eye Hospital from 1 st January - 31 st March 2017.Methods: Patients were identified from hospital records or polymerase chain reaction results.Results: 368 eyes of 224 patients, median age 35.3 (range 7-82) and 59.8% males, were included. 152 (67.9%) patients presented already on antibiotic treatment. Most patients (83.5%) had no previous ocular history aside from 35 (15.6%) who were regular contact lens wearers. PCR was performed in 170 (75.9%) patients, with 92 (54.1%) positive for adenovirus, and 7 (4.1%) for HSV. The average duration of symptoms prior to presentation was 6.3 days. 177 (78.0%) patients presented within 1 week of symptom onset and these patients were more likely to be adenovirus positive on PCR (OR = 2.37). Patients with symptoms of longer duration were more likely to have photophobia (OR = 2.96) and have had steroid treatment (OR = 3.80).Conclusions and Relevance: Patients with viral conjunctivitis typically presented within a week of symptom onset, with bilateral disease and on topical antibiotics. Pseudomembranes and a palpable preauricular lymph node were not common. As treatments emerge for viral conjunctivitis patients may need to be encouraged to present earlier. [ABSTRACT FROM AUTHOR]

Adenoviral conjunctivitis may lead to subepithelial corneal infiltrates as a late complication. Herein, we aim to present a 19-year-old healthy female, who developed bilateral disciform keratitis three weeks after suffering adenoviral conjunctivitis. She presented with widespread subepithelial corneal infiltrates in addition to central corneal edema with white distinct border resembling immune stromal ring, as well as Descemet's folds and keratic precipitates in the central area. Following topical corticosteroid and ganciclovir for 10 days, her condition improved. After 1 month, she had another episode. Short-term topical corticosteroids in addition to long-term topical cyclosporine and nonpreserved artificial tears were able to prevent further recurrences.

The conjunctival epithelium covering the eye contains two main cell types: mucus-producing goblet cells and water-secreting keratinocytes, which present mucins on their apical surface. Here, we describe long-term expanding organoids and air-liquid interface representing mouse and human conjunctiva. A single-cell RNA expression atlas of primary and cultured human conjunctiva reveals that keratinocytes express multiple antimicrobial peptides and identifies conjunctival tuft cells. IL-4/-13 exposure increases goblet and tuft cell differentiation and drastically modifies the conjunctiva secretome. Human NGFR+ basal cells are identified as bipotent conjunctiva stem cells. Conjunctival cultures can be infected by herpes simplex virus 1 (HSV1), human adenovirus 8 (hAdV8), and SARS-CoV-2. HSV1 infection was reversed by acyclovir addition, whereas hAdV8 infection, which lacks an approved drug therapy, was inhibited by cidofovir. We document transcriptional programs induced by HSV1 and hAdV8. Finally, conjunctival organoids can be transplanted. Together, human conjunctiva organoid cultures enable the study of conjunctival (patho)-physiology., Competing Interests: Declaration of interests H.C. is the head of Pharma Research and Early Development at Roche, Basel and holds several patents related to organoid technology. M.B.-H. and H.C. are inventors on a filed patent application related to this work., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Conjunctivitis is a common eye condition involving inflammation and in some instances infection of the conjunctiva. In the majority of cases it is caused by adenoviruses and, to a lesser extent, bacteria. Conjunctivitis can also occur secondary to Chlamydial and Gonococcal infections and new-born infants can acquire it during the birthing process from infected mothers. Herpes simplex and Herpes zoster are the infective organisms also responsible for conjunctivitis while seasonal pollens are usually the cause for allergic conjunctivitis. Common symptoms and signs are redness, tearing, oedema of the eyelids, sensation of a foreign body and it may be accompanied by itching. Most often a purulent discharge and adherence of eyelids at awakening are indicators of a bacterial infection. Most of the uncomplicated acute cases are self-limiting. There is however a challenge in distinguishing between the various types of conjunctivitis due to the similarity in the symptoms and due to a lack of tests and prediction algorithms, thus antibiotic therapy is often incorrectly initiated. Treatment of acute uncomplicated conjunctivitis caused by adenoviruses and bacteria is mostly symptomatic. Topical eye drops and ointments are preferred to oral agents in the treatment of more severe bacterial and allergic conjunctivitis while oral agents are used in the treatment of conjunctivitis caused by Herpes simplex, Herpes zoster, Chlamydia trachomatis and Neisseria gonorrhoeae. [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinical features and microstructural characteristics assessed by in vivo confocal microscopy (IVCM) in patients with adenoviral epidemic keratoconjunctivitis (EKC). Materials and Methods: The study included 20 eyes of 12 patients who presented to the Kocaeli University Medical Faculty, Department of Ophthalmology with complaints of watering, crusting, and stinging, were clinically diagnosed EKC, and were examined by slit-lamp biomicroscopy and IVCM during the prodromal phase and the punctate keratitis, deep epithelial keratitis, and subepithelial infiltration stages of EKC. Results: While biomicroscopic examination findings were normal during the prodromal period of EKC, IVCM showed an increase in Langerhans cell numbers in the subbasal plexus. After onset of clinical EKC, the punctate epithelial keratitis stage was characterized by findings of hyperreflective cell clusters in the basal epithelium layer, increased accumulation of Langerhans cells in Bowman's layer, and hyperreflectivity in the anterior stromal layers. In the deep epithelial keratitis stage, the basal epithelial cells displayed peripheral hyperreflectivity and the hyperreflectivity of the anterior stromal surface increased and became more rounded. In the subepithelial keratitis stage, these findings persisted in addition to increased anterior stromal surface hyperreflectivity and focal round plaques. Conclusion: This study shows that the inflammatory process in the cornea starts in the prodromal period of EKC. Massive inflammation of the epithelium and stroma was observed in the active phase and focal changes were observed on the anterior stromal surface starting in the subepithelial infiltration period. [ABSTRACT FROM AUTHOR]

In the article, the editors reflect on the effects of pneumococcal conjugate vaccines (PCV) on bacterial conjunctivitis in children. Other topics include the number of primary care office visits in the U.S. due to acute infectious conjunctivitis, how bacteria and respiratory viruses cause the disease, and the effects of PCV13 on bacterial colonization of the nasopharynx.

We report a rare case of very late-onset haze triggered by viral conjunctivitis, > 20 years after treatment of moderate myopia with photorefractive keratectomy (PRK), and its successful management. [ABSTRACT FROM AUTHOR]

Purpose: To detect the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimens of coronavirus disease-19 (COVID-19) patients.Methods: Forty-five COVID-19 patients positive for real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasopharyngeal swab with or without ocular manifestations were included in the study. The conjunctival swab of each patient was collected by an ophthalmologist posted for COVID duty.Results: Out of 45 patients, 35 (77.77%) were males and the rest were females. The mean age was 31.26 ± 12.81 years. None of the patients had any ocular manifestations. One (2.23%) out of 45 patients was positive for RT-PCR SARS-CoV-2 in the conjunctival swab.Conclusion: This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19. [ABSTRACT FROM AUTHOR]

Dengue virus and Zika virus coexist in tropical regions in Asia where healthcare resources are limited; differentiating the 2 viruses is challenging. We showed in a case-control discovery cohort, and replicated in a validation cohort, that the diagnostic indices of conjunctivitis, platelet count, and monocyte count reliably distinguished between these viruses. [ABSTRACT FROM AUTHOR]

Viral conjunctivitis, mainly caused by Adenovirus, is currently a health problem to be solved. The increase in infection in recent years and the morbidity that can be associated despite treatment, make it an infectious disease whose knowledge and study is essential for the ophthalmologist. An exhaustive bibliographic review of the main articles published was carried out using the keywords: hemorrhagic conjunctivitis, epidemic keratoconjunctivitis, and adenovirus conjunctivitis, with the aim of discussing the main features, the new diagnostic methods, treatments, quitar and possible complications and clinical implications of the epidemic keratoconjunctivitis. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the sequelae due to epidemic viral conjunctivitis (VC) for a possible association with inflammatory trachoma in schoolchildren.Methods: A cross-sectional survey was performed of 2,093 schoolchildren in public schools in Sao Paulo State, Brazil. The exams were conducted according to the WHO definitions to detect trachoma. We evaluated the prevalence and the association between inflammatory trachoma and sequelae due to VC.Results: The prevalence of inflammatory trachoma in schoolchildren in Botucatu City was 2.9% (CI: 1.2-17.3%). The prevalence of sequelae from VC was 0.007% (CI: 0 to 0.033%). Acute bacterial conjunctivitis was detected in 0.001%. There was no association between inflammatory trachoma and VC-related sequelae or acute bacterial conjunctivitis.Conclusion: An outbreak of epidemic VC can lead to definitive sequelae in the tarsal conjunctiva. The sequelae from VC were detected in 0.007% of the schoolchildren and were not associated with inflammatory trachoma. [ABSTRACT FROM AUTHOR]