Introduction Epidemic keratoconjunctivitis is the most severe form of adenoviral conjunctivitis. Although corneal involvement with subepithelial infiltrates and superficial punctate keratitis is common in epidemic keratoconjunctivitis, large geographic corneal defects are rarely encountered or documented. We present 3 patients who developed corneal epithelial defects with epidemic keratoconjunctivitis, discuss suspected pathophysiologies, and review how the patients were managed. Case Reports Three patients presented to the Illinois Eye Institute with similar, but uncommon, clinical presentations of epidemic keratoconjunctivitis over a 2-year period. All patients developed a unilateral, large-diameter, central corneal epithelial defect during their infection. With proper treatment, the defects and the viral infections healed, leaving no permanent visual complications in all 3 patients. Conclusion Epidemic keratoconjunctivitis’ distinguishing clinical features include severe conjunctivitis, subepithelial infiltrates, and superficial punctate keratitis. Geographic corneal defect, although less reported and understood, is another potential clinical finding. An epithelial defect worsens patients’ symptoms, raises concern for secondary infection, and complicates the treatment options. Clinicians should be aware of this more severe presentation and understand the management challenges it presents.
Hohs et al. (Mon,) studied this question.