Stages of EKC

-EKC causes the most severe form of adenoviral conjunctivitis. 7-10 days after inoculation, patients develop a severe follicular conjunctivitis and punctate keratitis.
-The conjunctival inflammation ranges from mild inflammation and a mixed follicular/papillary reaction to a severe reaction with subconjunctival hemorrhage, true and pseudomembranes.
-Keratitis (i.e. corneal inflammation) does not always occur in EKC, but if it does, can be classified into stages which are seen above

-Patients develop multifocal subepithelial infiltrates about 7-14 days after ocular symptoms start.
-Therapy is supportive and steroids should only be used if there is vision threatening subepithelial infiltrates or conjunctival membranes.
-Steroids can prolong the course of the disease and some patients may need them permanently once started.

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