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Persistent Symblepharon in an Infant Following Epidemic Keratoconjunctivitis
Sezen Akkaya1, Yelda Buyru Ozkurt1
1Fatih Sultan Mehmet Training and Research Hospital, Ophthalmology Department, E-5 uzeri, ust bostanci, Istanbul, Turkey.
Insights
Epidemic keratoconjunctivitis (EKC) can lead to symblepharon in infants, a rare complication where eye tissues adhere. This case highlights the need for careful monitoring and oral steroid treatment in affected infants.
Area of Science:
- Ophthalmology
- Virology
- Pediatrics
Background:
- Epidemic keratoconjunctivitis (EKC) is a severe, contagious eye infection caused by human adenoviruses (Ads).
- It characteristically involves conjunctival and corneal inflammation with subepithelial leukocyte infiltration, potentially causing persistent corneal opacities.
Observation:
- This report details a rare case of symblepharon formation in a 6-month-old infant following EKC.
- Symblepharon involves the adhesion of the palpebral conjunctiva to the bulbar conjunctiva, significantly impacting ocular health.
Findings:
- This is the first documented case of symblepharon in an infant secondary to EKC.
- The occurrence is notable as symblepharon is typically associated with other conditions, not commonly EKC, and is exceptionally rare in infants.
Implications:
- The findings underscore the potential for unusual complications of EKC in pediatric populations.
- Management challenges include severe eyelid edema precluding topical treatment, necessitating oral steroid therapy under strict pediatric supervision.
Abstract:
Epidemic keratoconjunctivitis (EKC), caused by certain species D human adenoviruses (Ads), is a highly contagious severe disease involving both the conjunctiva and cornea. The hallmark of this disease is the subepithelial infiltration of leukocytes, which results in corneal opacities that may persist for months or even years. In this case, of a 6-month-old infant, we report a symblepharon formation, a relatively rare outcome of EKC. In this condition, the palpebral conjunctiva adheres tightly to the bulbar conjunctiva of the eyeball. Our report is the first documentation of a symblepharon formation in an infant. Only two similar cases have been reported to date; therefore, a detailed description is of considerable interest to ophthalmologists. This is particularly interesting since a previous publication has associated symblepharon formation with an adenovirus infection, which is not usually involved in EKC. The development of a symblepharon following EKC is rare in infants. Since topical treatment cannot be applied due to severe eyelid edema, oral steroid therapy can be administered with pediatric consultation and meticulous monitoring.
