Epidemic keratoconjunctivitis (EKC) is the most severe ocular infection caused by adenovirus and is classically associated with serotypes 8, 19, and 37. In children pharyngoconjunctival fever (PCF) due to HAdV types 3, 4, and 7 results in acute follicular conjunctivitis with fever, pharyngitis, periauricular lymphadenopathy. Up to 90% of viral conjunctivitis cases are caused by adenoviruses. Washing hands and avoidance of eye contact are key to preventing transmission to others. Most cases of viral conjunctivitis are highly contagious for 10-14 days. Viral conjunctivitis can be obtained by direct contact with the virus, airborne transmission, and reservoir such as swimming pools. Children are most susceptible to viral infections, and adults tend to get more bacterial infections. Frequently associated infections caused by the adenovirus include upper respiratory tract infections, eye infections, and diarrhea in children. The adenovirus is part of the Adenoviridae family that consists of a nonenveloped, double-stranded DNA virus. The most common cause of viral conjunctivitis is adenoviruses. The portion covering the scleral is referred to as the bulbar conjunctiva, and the portion on the posterior surface of the lids is the palpebral conjunctiva. The conjunctiva starts at the limbus of the cornea and covers both the sclera and posterior surface of the eyelids. The conjunctiva is a thin semitransparent membrane that covers the white part of the eye called the sclera. Due to the non-specificity of signs and symptoms, a thorough medical and ophthalmic history with clinical examination should be obtained, especially in patients with atypical signs and a chronic course. Specific treatments for viral conjunctivitis are currently being assessed in clinical trials. Improvement in diagnostic rates of viral conjunctivitis is estimated to have reduced inappropriate antibiotic prescribing and saved US $430 million per year in the United States. The rates of antibiotic treatment in the community for patients with infectious conjunctivitis in the United Kingdom range between 80% and 95%. Prescribing antibiotics in cases of viral conjunctivitis is one of the major costs of any healthcare system. There is a considerable economic and societal impact due to the costs of visits to the emergency department or general practitioner, diagnostic tests, prescription treatment, and time lost from work or school. Characteristics of viral conjunctivitis include redness, blood vessel engorgement, ocular discharge, pain, photophobia, and pseudomembranes. Viral conjunctivitis is responsible for the majority of infectious conjunctivitis, accounting for up to 75% of cases. Conjunctivitis is one of the most common causes of red-eye and affects patients of all ages and socioeconomic class.
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