EKC vs PCF

[sco1styear]

We haven't gone into too much depth about these two yet but I was wondering if someone could explain how you differentiate the two. Is it subepi infiltrates or corneal involvement? What do you look for to know which type it is?

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[r_salis]

From Review of Optometry's "Handbook of Ocular Disease Management":
(full article here: http://www.revoptom.com/handbook/SECT2B.HTM )

Pharyngoconjunctival fever (PCF) is characterized by fever, sore throat and follicular conjunctivitis. It may be unilateral or bilateral. It is caused regularly by adenovirus 3 and occasionally 4 or 7. Corneal infiltrates are rare. The disorder varies in severity but usually persists for four days to two weeks. While the virus is shed from the conjunctiva within 14 days, it remains in fecal matter for 30 days.

Epidemic Keratoconjunctivitis (EKC) often presents as a bilateral, inferior, palpebral, follicular conjunctivitis, with epithelial and stromal keratitis. Subepithelial corneal infiltrates are much more common in EKC than in PCF and are typically concentrated in the central cornea. EKC is regularly caused by adenovirus types 8 and 19.

 

[sco1styear]

From Review of Optometry's "Handbook of Ocular Disease Management":
(full article here: http://www.revoptom.com/handbook/SECT2B.HTM )

Pharyngoconjunctival fever (PCF) is characterized by fever, sore throat and follicular conjunctivitis. It may be unilateral or bilateral. It is caused regularly by adenovirus 3 and occasionally 4 or 7. Corneal infiltrates are rare. The disorder varies in severity but usually persists for four days to two weeks. While the virus is shed from the conjunctiva within 14 days, it remains in fecal matter for 30 days.

Epidemic Keratoconjunctivitis (EKC) often presents as a bilateral, inferior, palpebral, follicular conjunctivitis, with epithelial and stromal keratitis. Subepithelial corneal infiltrates are much more common in EKC than in PCF and are typically concentrated in the central cornea. EKC is regularly caused by adenovirus types 8 and 19.

Yeah, that didn't seem cut and dry enough since it sounds like PCF may also haev infiltrates. I didn't know if there was something else you went by or if you just typically say it's EKC whenever you see infiltrates.

 

[r_salis]

The thing I seem to remember stressed in lecture about PCF is the "pharyngo" component -- if someone presents with a fever and sore throat along with conjuctivitis, you go with a diagnosis of PCF.

*edit* ... so I guess if you *don't* see the fever/sore throat and you have infiltrates, you can probably assume EKC.

 

[sco1styear]

So, what if you have a teacher who had a lot of students that had colds and had been absent from class (presumably with "pink eye"). The teacher had a cold 1wk ago and presents with itchy, red, watery eyes, preauricular lymphadenopathy, diffuse spk, and scattered subepi infiltrates. Which one would you call it?
(this is a hypothetical case)

 

[r_salis]

I'd probably call it PCF because of the cold symptoms, if I was asked to make a diagnosis based on case history.

 

[sco1styear]

I'd probably call it PCF because of the cold symptoms, if I was asked to make a diagnosis based on case history.

Thanks for all your input! 👍