Korean J Ophthalmol.  2011 Aug;25(4):257-261. 10.3341/kjo.2011.25.4.257.

Amblyopia and Strabismus by Monocular Corneal Opacity Following Suspected Epidemic Keratoconjunctivitis in Infancy

• Gu B
• Son J
• Kim M

• KMID: 1018414
• DOI: http://doi.org/10.3341/kjo.2011.25.4.257

Abstract

PURPOSE
To identify the long term clinical course of amblyopia and strabismus that developed secondary to a monocular corneal opacity following suspected epidemic keratoconjunctivitis (EKC) in infancy.
METHODS
This was a retrospective study analyzing the medical records of seven patients, treated in our clinic, who were followed for more than five years.
RESULTS
Four patients in our clinic underwent a corneal ulcer treatment following suspected EKC. Each developed a monocular corneal opacity. Three patients with a chief complaint of corneal opacity were transferred to our clinic from other clinics. These patients had documented histories of treatment for EKC in infancy. All patients were treated with early occlusion therapy, but amblyopia persisted in four patients. Furthermore, all patients had strabismus and showed a significant reduction of stereoscopic vision.
CONCLUSIONS
Although infants with EKC are not always cooperative, slit lamp examination should be performed as early as possible, and appropriate medical treatment should be performed, thus reducing the development of corneal opacity. Careful follow up should be regularly performed, and the occurrence of amblyopia or strabismus should be verified at an early stage using visual acuity or ocular alignment examination. Ophthalmologic treatments, including active occlusion therapy, should also be pursued.

Keyword

Amblyopia; Corneal opacity; Keratoconjunctivitis; Strabismus

MeSH Terms

Adenoviridae Infections/*complications/diagnosis/epidemiology
Amblyopia/*etiology/pathology/physiopathology
Child
Child, Preschool
Corneal Opacity/*complications/pathology
Disease Progression
*Epidemics
Eye Infections, Viral/*complications/diagnosis/epidemiology
Female
Follow-Up Studies
Humans
Infant
Keratoconjunctivitis/*complications/diagnosis/epidemiology
Male
Prognosis
Refraction, Ocular
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Strabismus/*etiology/pathology/physiopathology
Vision, Binocular
Visual Acuity

Reference

1. Kim SY, Park KS, Kim JH, Kim SM. A statistic observation of the clnical epidemic keratoconjunctivitis. J Korean Ophthalmol Soc. 1969. 10:15–19.

2. Ishii K, Nakazono N, Fujinaga K, et al. Comparative studies on aetiology and epidemiology of viral conjunctivitis in three countries of East Asia--Japan, Taiwan and South Korea. Int J Epidemiol. 1987. 16:98–103.

3. Schrauder A, Altmann D, Laude G, et al. Epidemic conjunctivitis in Germany, 2004. Euro Surveill. 2006. 11:185–187.

4. Lund OE, Stefani FH. Corneal histology after epidemic keratoconjunctivitis. Arch Ophthalmol. 1978. 96:2085–2088.

5. Alsuhaibani AH, Sutphin JE, Wagoner MD. Confocal microscopy of subepithelial infiltrates occurring after epidemic keratoconjunctivitis. Cornea. 2006. 25:1102–1104.

6. Von Noorden GK. Factors involved in the production of amblyopia. Br J Ophthalmol. 1974. 58:158–164.

7. Beneish RG, Williams FR, Polomeno RC, Flanders ME. Herpes simplex keratitis and amblyopia. J Pediatr Ophthalmol Strabismus. 1987. 24:94–96.

8. Cameron JA, Mullaney PB. Amblyopia resulting from shield ulcers and plaques of the cornea in vernal keratoconjunctivitis. J Pediatr Ophthalmol Strabismus. 1997. 34:261–262.

9. Chong EM, Wilhelmus KR, Matoba AY, et al. Herpes simplex virus keratitis in children. Am J Ophthalmol. 2004. 138:474–475.

10. Jones SM, Weinstein JM, Cumberland P, et al. Visual outcome and corneal changes in children with chronic blepharokeratoconjunctivitis. Ophthalmology. 2007. 114:2271–2280.

11. Fantes FE, Hanna KD, Waring GO 3rd, et al. Wound healing after excimer laser keratomileusis (photorefractive keratectomy) in monkeys. Arch Ophthalmol. 1990. 108:665–675.

12. Jin YH. A new logMAR vision chart: Jin's vision chart. J Korean Ophthalmol Soc. 1997. 38:2036–2044.

13. Lee BH, Kim MM. Comparisons of the Lang, Randot, TNO and new stereo tests in screening and office use in children. J Korean Ophthalmol Soc. 1990. 31:651–660.