Management
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Î For patients with membranous conjunctivitis, debridement of the
membrane can be considered to prevent corneal epithelial abrasions
or permanent cicatricial changes. (III, I, D)
Î Patients with severe disease who have corneal epithelial ulceration or
membranous conjunctivitis should be re-evaluated within 1 week.
(III, I, D)
Î The follow-up visit should include an interval history, measurement of
visual acuity, and slit-lamp biomicroscopy. (III, I, D)
Î Patients who are prescribed prolonged topical corticosteroids should be
monitored using periodic measurement of IOP and pupillary dilation to
evaluate for glaucoma and cataract. (III, I, D)
Î Topical corticosteroids should be tapered once inflammation is
controlled. (III, I, D)
Î Patients who are not treated with topical corticosteroids should
be instructed to return for follow-up if they continue to experience
symptoms of red eye, pain, or decreased vision after 2–3 weeks.
(III, I, D)
Î This follow-up visit should include an interval history, measurement of
visual acuity, and slit-lamp biomicroscopy. (III, I, D)
Î During follow-up, patients should be evaluated for the presence of
corneal subepithelial infiltrates, which typically occur ≥1 week after
the onset of conjunctivitis. (III, I, D)
Î In mild cases, observation is sufficient. (III, I, D)
Î In cases with blurring, photophobia, and decreased vision, topical
corticosteroids at the minimum effective dose may be considered.
(III, I, D)
Î Cyclosporine 1% may be a corticosteroid-sparing agent that is useful
in the management of this post-EKC condition. (II-, I, D)
Î Patients who are being treated with topical corticosteroids should
have the dosage slowly tapered to the minimum effective dose.
(III, I, D)
Î A follow-up examination should be conducted every 4–8 weeks, and
visits should include an interval history, measurement of visual acuity
and IOP, and slit-lamp biomicroscopy. (III, I, D)
