Adenovirus keratoconjunctivitis: an enigma.

'Adenovirus keratoconjunctivitis' is a diagnosis commonly made in Eye Casualty Departments. There are no clinical features that allow identification of the serotype causing the infection. The changeable patterns of presentation and manifestation of the different serotypes and the capacity of adenovirus to mimic other viral or bacterial infections is an enigma. Adenovirus infections are usually self-limiting; permanent visual loss is very rare. The use of corticosteroids is generally limited to cases with severe symptoms such as glare and incapacitating blurring of vision. Corticosteroids will not alter the basic pathogenesis of the disease but will suppress inflammatory signs. The sub-epithelial lesions are an immunopathological phenomenon resulting from the interaction of viral antigen and antibody in the anterior stroma with the cornea acting as a 'blotter'. An effective antiviral remains elusive.