|Year : 1973 | Volume
| Issue : 1 | Page : 23-24
A study of fifty cases of keratoconjunctivitis
E Ahmed, SN Roy
Department of Ophthalmology, Bankura Samilani Medical College, Calcutta, India
Department of Ophthalmology, Bankura Samilani Medical College, Calcutta
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ahmed E, Roy S N. A study of fifty cases of keratoconjunctivitis. Indian J Ophthalmol 1973;21:23-4
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|| |
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|| |
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|| |
Treatment consisted of topical antibiotic (in most instances chloramphenicol) and atropine.
| Discussion|| |
WEERKOON  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  ) 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:
(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|| |
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|| |
Ahmed, E. and Bose, J.: `Incidence of Ophthalmic Diseases'. Bull. Madras Ophthal. A. 1: 107, 1964.
Duke-Elder, S.: in `System of Ophthalmology'. Vol. 8, Part 2,
1965, Kimpton, London.
Thygeson, P.: `Clinical and Laboratory Observations on Superficial Punctate Keratitis', Amer. J. Ophthal., 61: 1344, 1966.
Weerkoon, L. M.: `Epidemic Keratoconjunctivitis in Ceylon'. Brit. J. Ophthal., 40: 691, 1956.
Yin-Coggrave, M. and Loh, R. C. K.: `Etiologic and clinical studies of Epidemic Keratoconjunctivitis in Singapur, Amer. J. Ophthal., 61: 515. 1966.
[Table - 1], [Table - 2]