A CLINICAL STUDY OF THE PATIENTS OF VIRAL CONJUNCTIVITIS IN REMOTE AREA

Abstract

Introduction: According to WHO, corneal diseases are responsible for nine per
cent of all blindness in India. Viral keratitis has become more prevalent now.
Adenovirus is the most common cause and tends to become epidemic. It can
cause nummular corneal opacities impairing visual function significantly.
Objective: 1. To find out commonest etiological agent of viral conjunctivitis. 2.
To determine the most common serotype of adenovirus causing corneal opacity.
Materials and Methods: A cross sectional study was conducted for one year
with informed consent among 100 patients attending the Regional Institute of
Ophthalmology, with clinical features suggestive of Viral Conjunctivitis.
Detailed clinical evaluation followed by collection of two conjunctival swab for
Gram’s staining and for Polymerase chain reaction was done for each patient.
PCR sequences obtained were edited in Bio Edit software (V.7.0.9.0) and
compared with adenoviral sequences present in GenBank using the BLAST-N
program (version 2.2.18). The patients were further followed up weekly until
the conjunctivitis resolved. Clinical course of the corneal lesion was followed
up for three months. Results: The major ocular symptoms were redness (100%),
pain (59%), watering (56%) and mucoid discharge (41%). Fifty six per cent of
the patients had pre-auricular lymph node enlargement. The most common
conjunctival findings was acute follicular conjunctivitis with fine petechial
hemorrhages (45.8%). Viral PCR was positive in 24 per cent of patients and
subtyping showed adenovirus 8 (70.8%), adenovirus 3 (16.6%), adenovirus 19
(8.3%) and adenovirus 24 (4.16%). Twenty one per cent of the patients
developed superficial punctate epitheliopathy. Of these, 75 per cent were viral
PCR positive. Fifteen per cent of the patients had persistent subepithelial
opacity at the end of three months. Conclusion: Viral conjunctivitis is a
common ocular condition among the outpatients. The present study shows that
Adenovirus 8 was the most common etiological agent causing viral
conjunctivitis and most common serotype causing corneal subepithelial
opacities which affect the visual clarity.