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ARTICLES
Year : 1973  |  Volume : 21  |  Issue : 1  |  Page : 23-24

A study of fifty cases of keratoconjunctivitis


Department of Ophthalmology, Bankura Samilani Medical College, Calcutta, India

Correspondence Address:
E Ahmed
Department of Ophthalmology, Bankura Samilani Medical College, Calcutta
India
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Source of Support: None, Conflict of Interest: None


PMID: 4793002

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How to cite this article:
Ahmed E, Roy S N. A study of fifty cases of keratoconjunctivitis. Indian J Ophthalmol 1973;21:23-4

How to cite this URL:
Ahmed E, Roy S N. A study of fifty cases of keratoconjunctivitis. Indian J Ophthalmol [serial online] 1973 [cited 2020 Nov 26];21:23-4. Available from: https://www.ijo.in/text.asp?1973/21/1/23/31424

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Table 1

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Table 1

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The incidence of unilateral kerato­conjunctivitis with preauricular lym­phadenopathy following bath in muddy water more frequently during September to December has been al­ready reported (AHMED AND BOSE 1954).

The present communication con­cerns fifty such consecutive cases.


  Methods and Material Top


Fifty patients having unilateral red­ness unaccompanied by frank conjunc­tival discharge were examined at the Eye Outpatients' of Bankura Sammi­lani Medical College (West Bengal) between 1st August, 1967 and 31st December, 1967.

History had been elicited in each case regarding ocular symptoms, pre­ceding or associated coryza, type of water used for bathing and treatment already done.

Examination of the conjunctiva and cornea by oblique illumination and corneal loupe, testing corneal sensi­bility by a wisp of cotton wool in each eye, recording of the visual acuity and palpation of preauricular glands were done as a routine. Evidence of coryza had been looked for.


  Observations Top


The ocular affection almost certain­ly started after a dip in muddy water. All the cases hailed from the rural areas. The condition was characteris­tically seasonal reaching its peak in September (August-12, September­25, October-10, November-3, December-nil). The affection was commoner in males (38) than in females (12), majority of them were adults [Table - 1]. Right and left eyes had been involved in 27 and 23 cases respectively.

Forty-seven out of fifty cases had been using muddy water, two using tubewell water and one using tap water. Thirty out of fifty cases had some evidence of coryza and more often ocular symptoms had started 2-3 days after the onset of common cold. Most of them visited the Eye Out­patients on the third or fourth day after the onset of ocular symptoms. Eleven patients confessed that they had applied penicillin eye ointment without the advice of an Ophthalmo­logist prior to the visit to the hospital.

Onset was acute in most instances accompanied by dull aches in the eye, watering, photophobia and redness. The signs of the disease were tabulat­ed [Table - 2]. Mild to moderate disturbance of visual acuity was com­moner than gross disturbance at the initial visit.

It appeared that if the preauricular gland on the affected side would not be enlarged within a few days of onset of the disease, the ocular involve­ment had been more severe.

The final clinical picture was that of either clear cornea (20) or corneal opacity (20). Ten patients could not be followed up adequately.

The course of the disease was short­lived in majority of the cases-varying between one to three weeks.


  Treatment Top


Treatment consisted of topical anti­biotic (in most instances chloramphe­nicol) and atropine.


  Discussion Top


WEERKOON [4] reviewed cases of epi­demic kerato-conjunctivitis following some mud or muddy water into the eyes while the patients were at work in the fields. DUKE-ELDER differen­tiated three conditions viz. epidemic kerato-conjunctivitis, pharyngo-con­junctival fever and Nummular kerati­tis, while THYGESON differentiated epi­demic kerato-conjunctivitis from `Superficial Punctate Keratitis'. The term 'adenovirus kerato-conjunctivi­tis' (YIN GOGGRAVE AND LOH [5] ) ap­pears to be fairly accurate when aetio­logy remains obscure.

It appears that our cases belong to adenovirus group. The reasons for this suggestion are as under:

(i) Unilaterality.

(ii) Absence of frank conjuncti­val discharge.

(iii) Lesions of cornea involving initially superficial layers. (iv) Impairment of corneal sensi­bility.

(v) Evidence of respiratory infec­tion.

(vi) Involvement of the preauricu­lar gland.


  Summary Top


Fifty cases of unilateral kerato-con­iunctivitis have been reviewed clini­cally as regards their age, sex, lateral­ity, possible source of infection, pre­ceding or associated coryza and pre­auricular lymphadenopathy. The af­fection is most probably viral and it usually follows after a dip in muddy water.

 
  References Top

1.
Ahmed, E. and Bose, J.: `Incidence of Ophthalmic Diseases'. Bull. Madras Ophthal. A. 1: 107, 1964.  Back to cited text no. 1
    
2.
Duke-Elder, S.: in `System of Ophthalmology'. Vol. 8, Part 2, 1965, Kimpton, London.  Back to cited text no. 2
    
3.
Thygeson, P.: `Clinical and Labo­ratory Observations on Superficial Punctate Keratitis', Amer. J. Oph­thal., 61: 1344, 1966.  Back to cited text no. 3
    
4.
Weerkoon, L. M.: `Epidemic Kera­toconjunctivitis in Ceylon'. Brit. J. Ophthal., 40: 691, 1956.  Back to cited text no. 4
    
5.
Yin-Coggrave, M. and Loh, R. C. K.: `Etiologic and clinical studies of Epidemic Keratoconjunctivitis in Singapur, Amer. J. Ophthal., 61: 515. 1966.  Back to cited text no. 5
    



 
 
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