HemoChat

Evidence-Based AI Medical Search

← Back to guidelines
Ophthalmology274 papers

Keratoconjunctivitis caused by adenovirus

Last edited: 4/14/2026

Overview

Keratoconus is a progressive, noninflammatory corneal ectasia characterized by thinning and conical protrusion of the cornea, leading to irregular astigmatism and decreased visual acuity. 14

Diagnosis

  • Clinical Examination: Presence of progressive corneal thinning and irregular corneal topography. 14
  • Corneal Topography: Utilization of corneal imaging devices (e.g., Scheimpflug imaging) for detailed topographic analysis. 444
  • Grading Systems: Use of standardized scales like the Amsler-Krumeich classification for severity assessment. 33

    • Management

  • First-Line Treatments:
    • - Rigid Gas Permeable (RGP) Contact Lenses: For visual rehabilitation and protection of the cornea. 2232 - Corneal Collagen Cross-Linking (CXL): To halt progression, typically epithelium-off technique. 319
  • Adjunctive Treatments:
    • - Pain Management: Ketorolac tromethamine 0.4% for pain associated with contact lens wear. 21 - Corneal Transplantation: Penetrating keratoplasty or Descemet Membrane Endothelial Keratoplasty (DMEK) for advanced cases. 71113

    Special Populations

  • Pediatrics: Early detection through routine corneal topography in children and adolescents from predisposed groups. 6
  • Comorbidities: Atopic conditions and excessive eye rubbing are associated with keratoconus progression; management should consider these factors. 43

    • Key Recommendations

  • Utilize corneal imaging devices for early and accurate diagnosis of keratoconus. (Evidence: Moderate) 4
  • Consider corneal collagen cross-linking as a first-line adjunctive treatment to halt disease progression in progressive cases. (Evidence: Moderate) 3
  • Rigid gas permeable contact lenses should be prescribed for visual rehabilitation in patients with keratoconus. (Evidence: Moderate) 22
  • Regular monitoring and early intervention are crucial, especially in pediatric populations to manage keratoconus effectively. (Evidence: Expert opinion) 6
  • Evaluate and manage potential atopic conditions and eye-rubbing habits to mitigate disease progression. (Evidence: Moderate) 43

    • References

    1 Bartolomeo N, Pederzolli M, Palombella S, Fonteyne P, Suanno G, Tilaro G et al.. The Effects of Vitamin D on Keratoconus Progression. American journal of ophthalmology 2025. link 2 Syed ZA, Tomaiuolo M, Zhang Q, Prajna V, Hyman L, Rapuano CJ. Trends and Sociodemographic Patterns in Keratoconus Management 2015-2020: An American Academy of Ophthalmology IRIS® Registry Analysis. Ophthalmology 2024. link 3 Cortina MS, Greiner MA, Kuo AN, Li JY, Miller DD, Shtein RM et al.. Safety and Efficacy of Epithelium-Off Corneal Collagen Cross-Linking for the Treatment of Corneal Ectasia: A Report by the American Academy of Ophthalmology. Ophthalmology 2024. link 4 Kuo AN, Cortina MS, Greiner MA, Li JY, Miller DD, Shtein RM et al.. Advanced Corneal Imaging in Keratoconus: A Report by the American Academy of Ophthalmology. Ophthalmology 2024. link 5 Seiler TG, Geerling G. Brillouin Spectroscopy in Ophthalmology. Klinische Monatsblatter fur Augenheilkunde 2023. link 6 Popová V, Tomčíková D, Bušányová B, Kecer F, Gerinec A, Popov I. Use of Corneal Topography in Pediatric Ophthalmology. Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti 2023. link 7 Almudhaiyan T, AlAmry M, Khandekar R, AlGhadeer H. Ocular emergencies visits after corneal transplantation at a tertiary eye care hospital in Saudi Arabia. International ophthalmology 2022. link 8 Gilevska F, Kostovska B, Osmani I, Biscevic A, Popovic Suic S, Bohac M et al.. Prevalence of keratoconus in refractive surgery practice population in North Macedonia. International ophthalmology 2022. link 9 Gupta PC, Pathak M, Thakur B, Fogla R, Agarwal A, Ram J. Association of keratoconus with serum levels of 25-hydroxyvitamin D and antioxidant trace elements: A systematic review and meta-analysis. Indian journal of ophthalmology 2022. link 10 Barbara A, Barbara R, Barua A, Alio J, Bandello F. Why a dedicated section on keratoconus in the European Journal of Ophthalmology?. European journal of ophthalmology 2021. link 11 Potts LB, Bauer AJ, Xu DN, Chen SY, Alqudah AA, Sanchez PJ et al.. The Last 200 Surgeon-Loaded Descemet Membrane Endothelial Keratoplasty Tissue Versus the First 200 Preloaded Descemet Membrane Endothelial Keratoplasty Tissue. Cornea 2020. link 12 Famery N, Abdelmassih Y, El-Khoury S, Guindolet D, Cochereau I, Gabison EE. Artificial chamber and 3D printed iris: a new wet lab model for teaching Descemet's membrane endothelial keratoplasty. Acta ophthalmologica 2019. link 13 Shimazaki J, Tomida D, Yamaguchi T, Satake Y. Descemet stripping automated endothelial keratoplasty performed by trainees. Japanese journal of ophthalmology 2019. link 14 Rana RS, Bajracharya L, Gurung R. Clinical Profile on Keratoconus Presenting at A Tertiary Eye Care Centre- Tilganga Institute of Ophthalmology. Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH 2019. link 15 Seitz B, Daas L, Bischoff-Jung M, Szentmáry N, Suffo S, El-Husseiny M et al.. Anatomy-based DMEK Wetlab in Homburg/Saar: Novel aspects of donor preparation and host maneuvers to teach descemet membrane endothelial keratoplasty. Clinical anatomy (New York, N.Y.) 2018. link 16 Shetty R, Deshmukh R, Ghosh A, Sethu S, Jayadev C. Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper. Indian journal of ophthalmology 2017. link 17 Gokul A, Patel DV, McGhee CN. Dr John Nottingham's 1854 Landmark Treatise on Conical Cornea Considered in the Context of the Current Knowledge of Keratoconus. Cornea 2016. link 18 Tenkman LR, Price FW, Price MO. Descemet membrane endothelial keratoplasty donor preparation: navigating challenges and improving efficiency. Cornea 2014. link 19 Shetty R, Shetty R, Mahendradas P, Shetty BK. Are the surgeons safe during UV-A radiation exposure in collagen cross-linking procedure?. Cornea 2012. link 20 . New treatments for keratoconus. The Medical letter on drugs and therapeutics 2011. link 21 Yu JO, Gundel RE. Use of Acular LS in the pain management of keratoconus: a pilot study. Optometry and vision science : official publication of the American Academy of Optometry 2010. link 22 Rabinowitz YS, Dong L, Wistow G. Gene expression profile studies of human keratoconus cornea for NEIBank: a novel cornea-expressed gene and the absence of transcripts for aquaporin 5. Investigative ophthalmology & visual science 2005. link 23 Sieber AN, Kostuik JP. Concepts in nuclear replacement. The spine journal : official journal of the North American Spine Society 2004. link 24 Kutzscher EM, Sorenson AL, Goodman DF. Penetrating keratoplasty performed by residents. Archives of ophthalmology (Chicago, Ill. : 1960) 2004. link 25 Owens H, Gamble G. A profile of keratoconus in New Zealand. Cornea 2003. link 26 Yaylali V, Kaufman SC, Thompson HW. Corneal thickness measurements with the Orbscan Topography System and ultrasonic pachymetry. Journal of cataract and refractive surgery 1997. link80113-7) 27 Varssano D, Rapuano CJ, Luchs JI. Comparison of keratometric values of healthy and diseased eyes measured by Javal keratometer, EyeSys, and PAR. Journal of cataract and refractive surgery 1997. link80187-3) 28 Parker J, Ko WW, Pavlopoulos G, Wolfe PJ, Rabinowitz YS, Feldman ST. Videokeratography of keratoconus in monozygotic twins. Journal of refractive surgery (Thorofare, N.J. : 1995) 1996. link 29 Gromacki SJ, Barr JT. Central and peripheral corneal thickness in keratoconus and normal patient groups. Optometry and vision science : official publication of the American Academy of Optometry 1994. link 30 Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology 1993. link31673-8) 31 Maloney RK, Bogan SJ, Waring GO. Determination of corneal image-forming properties from corneal topography. American journal of ophthalmology 1993. link73521-4) 32 Kok JH. A European fitting philosophy for aspheric, high-Dk RGP contact lenses. The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc 1992. link 33 McMahon TT, Robin JB, Scarpulla KM, Putz JL. The spectrum of topography found in keratoconus. The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc 1991. link 34 Pearson RM. Kalt, keratoconus, and the contact lens. Optometry and vision science : official publication of the American Academy of Optometry 1989. link 35 Koch DD, Foulks GN, Moran CT, Wakil JS. The Corneal EyeSys System: accuracy analysis and reproducibility of first-generation prototype. Refractive & corneal surgery 1989. link 36 Williams R. Acquired posterior keratoconus. The British journal of ophthalmology 1987. link 37 Hom MM. Another perspective on keratoconus contact lens fitting. Journal of the American Optometric Association 1986. link 38 Baumann J, Insler MS. Pupillary abnormalities in keratoconus. Annals of ophthalmology 1985. link 39 Newman PE. Castroviejo's square corneal grafts. Survey of ophthalmology 1984. link90189-9) 40 Klyce SD. Computer-assisted corneal topography. High-resolution graphic presentation and analysis of keratoscopy. Investigative ophthalmology & visual science 1984. link 41 Manning W, Miller D. Increasing the range of the keratometer. Survey of ophthalmology 1978. link90136-4) 42 Binder PS, Kohler JA, Rorabaugh DA. Evaluation of an electronic corneal pachometer. Investigative ophthalmology & visual science 1977. link 43 Karseras AG, Ruben M. Aetiology of keratoconus. The British journal of ophthalmology 1976. link

    Original source

    1. [1]
      The Effects of Vitamin D on Keratoconus Progression. — Bartolomeo N, Pederzolli M, Palombella S, Fonteyne P, Suanno G, Tilaro G et al. American journal of ophthalmology (2025)
    2. [2]
      Trends and Sociodemographic Patterns in Keratoconus Management 2015-2020: An American Academy of Ophthalmology IRIS® Registry Analysis. — Syed ZA, Tomaiuolo M, Zhang Q, Prajna V, Hyman L, Rapuano CJ Ophthalmology (2024)
    3. [3]
      Safety and Efficacy of Epithelium-Off Corneal Collagen Cross-Linking for the Treatment of Corneal Ectasia: A Report by the American Academy of Ophthalmology. — Cortina MS, Greiner MA, Kuo AN, Li JY, Miller DD, Shtein RM et al. Ophthalmology (2024)
    4. [4]
      Advanced Corneal Imaging in Keratoconus: A Report by the American Academy of Ophthalmology. — Kuo AN, Cortina MS, Greiner MA, Li JY, Miller DD, Shtein RM et al. Ophthalmology (2024)
    5. [5]
      Brillouin Spectroscopy in Ophthalmology. — Seiler TG, Geerling G Klinische Monatsblatter fur Augenheilkunde (2023)
    6. [6]
      Use of Corneal Topography in Pediatric Ophthalmology. — Popová V, Tomčíková D, Bušányová B, Kecer F, Gerinec A, Popov I Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti (2023)
    7. [7]
      Ocular emergencies visits after corneal transplantation at a tertiary eye care hospital in Saudi Arabia. — Almudhaiyan T, AlAmry M, Khandekar R, AlGhadeer H International ophthalmology (2022)
    8. [8]
      Prevalence of keratoconus in refractive surgery practice population in North Macedonia. — Gilevska F, Kostovska B, Osmani I, Biscevic A, Popovic Suic S, Bohac M et al. International ophthalmology (2022)
    9. [9]
      Association of keratoconus with serum levels of 25-hydroxyvitamin D and antioxidant trace elements: A systematic review and meta-analysis. — Gupta PC, Pathak M, Thakur B, Fogla R, Agarwal A, Ram J Indian journal of ophthalmology (2022)
    10. [10]
      Why a dedicated section on keratoconus in the European Journal of Ophthalmology? — Barbara A, Barbara R, Barua A, Alio J, Bandello F European journal of ophthalmology (2021)
    11. [11]
      The Last 200 Surgeon-Loaded Descemet Membrane Endothelial Keratoplasty Tissue Versus the First 200 Preloaded Descemet Membrane Endothelial Keratoplasty Tissue. — Potts LB, Bauer AJ, Xu DN, Chen SY, Alqudah AA, Sanchez PJ et al. Cornea (2020)
    12. [12]
      Artificial chamber and 3D printed iris: a new wet lab model for teaching Descemet's membrane endothelial keratoplasty. — Famery N, Abdelmassih Y, El-Khoury S, Guindolet D, Cochereau I, Gabison EE Acta ophthalmologica (2019)
    13. [13]
      Descemet stripping automated endothelial keratoplasty performed by trainees. — Shimazaki J, Tomida D, Yamaguchi T, Satake Y Japanese journal of ophthalmology (2019)
    14. [14]
      Clinical Profile on Keratoconus Presenting at A Tertiary Eye Care Centre- Tilganga Institute of Ophthalmology. — Rana RS, Bajracharya L, Gurung R Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH (2019)
    15. [15]
      Anatomy-based DMEK Wetlab in Homburg/Saar: Novel aspects of donor preparation and host maneuvers to teach descemet membrane endothelial keratoplasty. — Seitz B, Daas L, Bischoff-Jung M, Szentmáry N, Suffo S, El-Husseiny M et al. Clinical anatomy (New York, N.Y.) (2018)
    16. [16]
      Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper. — Shetty R, Deshmukh R, Ghosh A, Sethu S, Jayadev C Indian journal of ophthalmology (2017)
    17. [17]
      Dr John Nottingham's 1854 Landmark Treatise on Conical Cornea Considered in the Context of the Current Knowledge of Keratoconus. — Gokul A, Patel DV, McGhee CN Cornea (2016)
    18. [18]
      Descemet membrane endothelial keratoplasty donor preparation: navigating challenges and improving efficiency. — Tenkman LR, Price FW, Price MO Cornea (2014)
    19. [19]
      Are the surgeons safe during UV-A radiation exposure in collagen cross-linking procedure? — Shetty R, Shetty R, Mahendradas P, Shetty BK Cornea (2012)
    20. [20]
      New treatments for keratoconus. The Medical letter on drugs and therapeutics (2011)
    21. [21]
      Use of Acular LS in the pain management of keratoconus: a pilot study. — Yu JO, Gundel RE Optometry and vision science : official publication of the American Academy of Optometry (2010)
    22. [22]
      Gene expression profile studies of human keratoconus cornea for NEIBank: a novel cornea-expressed gene and the absence of transcripts for aquaporin 5. — Rabinowitz YS, Dong L, Wistow G Investigative ophthalmology & visual science (2005)
    23. [23]
      Concepts in nuclear replacement. — Sieber AN, Kostuik JP The spine journal : official journal of the North American Spine Society (2004)
    24. [24]
      Penetrating keratoplasty performed by residents. — Kutzscher EM, Sorenson AL, Goodman DF Archives of ophthalmology (Chicago, Ill. : 1960) (2004)
    25. [25]
      A profile of keratoconus in New Zealand. — Owens H, Gamble G Cornea (2003)
    26. [26]
      Corneal thickness measurements with the Orbscan Topography System and ultrasonic pachymetry. — Yaylali V, Kaufman SC, Thompson HW Journal of cataract and refractive surgery (1997)
    27. [27]
      Comparison of keratometric values of healthy and diseased eyes measured by Javal keratometer, EyeSys, and PAR. — Varssano D, Rapuano CJ, Luchs JI Journal of cataract and refractive surgery (1997)
    28. [28]
      Videokeratography of keratoconus in monozygotic twins. — Parker J, Ko WW, Pavlopoulos G, Wolfe PJ, Rabinowitz YS, Feldman ST Journal of refractive surgery (Thorofare, N.J. : 1995) (1996)
    29. [29]
      Central and peripheral corneal thickness in keratoconus and normal patient groups. — Gromacki SJ, Barr JT Optometry and vision science : official publication of the American Academy of Optometry (1994)
    30. [30]
      Videokeratography of the fellow eye in unilateral keratoconus. — Rabinowitz YS, Nesburn AB, McDonnell PJ Ophthalmology (1993)
    31. [31]
      Determination of corneal image-forming properties from corneal topography. — Maloney RK, Bogan SJ, Waring GO American journal of ophthalmology (1993)
    32. [32]
      A European fitting philosophy for aspheric, high-Dk RGP contact lenses. — Kok JH The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc (1992)
    33. [33]
      The spectrum of topography found in keratoconus. — McMahon TT, Robin JB, Scarpulla KM, Putz JL The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc (1991)
    34. [34]
      Kalt, keratoconus, and the contact lens. — Pearson RM Optometry and vision science : official publication of the American Academy of Optometry (1989)
    35. [35]
      The Corneal EyeSys System: accuracy analysis and reproducibility of first-generation prototype. — Koch DD, Foulks GN, Moran CT, Wakil JS Refractive & corneal surgery (1989)
    36. [36]
      Acquired posterior keratoconus. — Williams R The British journal of ophthalmology (1987)
    37. [37]
      Another perspective on keratoconus contact lens fitting. — Hom MM Journal of the American Optometric Association (1986)
    38. [38]
      Pupillary abnormalities in keratoconus. — Baumann J, Insler MS Annals of ophthalmology (1985)
    39. [39]
      Castroviejo's square corneal grafts. — Newman PE Survey of ophthalmology (1984)
    40. [40]
      Computer-assisted corneal topography. High-resolution graphic presentation and analysis of keratoscopy. — Klyce SD Investigative ophthalmology & visual science (1984)
    41. [41]
      Increasing the range of the keratometer. — Manning W, Miller D Survey of ophthalmology (1978)
    42. [42]
      Evaluation of an electronic corneal pachometer. — Binder PS, Kohler JA, Rorabaugh DA Investigative ophthalmology & visual science (1977)
    43. [43]
      Aetiology of keratoconus. — Karseras AG, Ruben M The British journal of ophthalmology (1976)
    Share:TwitterRedditLinkedIn

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG