By Helena M. Tabery

Despite adjustments in frequency, causation, and infectivity, adenovirus epithelial keratitis and Thygeson's superficial punctate keratitis (TSPK) are usually harassed in scientific perform as a result of the similarity among adenovirus epithelial infiltrates and ‘coarse’ epithelial TSPK lesions. This publication offers the morphological good points, dynamics, and sequelae of adenovirus and Thygeson's keratitides captured at excessive magnification within the dwelling human cornea. It thereby fills the prevailing void among traditional photos and slit-lamp observations. Case reviews exhibit the significance of sufferer heritage in differential analysis, illustrate the necessity for familiarity with early manifestations of adenovirus infections, and help in the analysis of infrequent variations of TSPK. in addition, the special observations at the common process the illnesses make sure that the booklet will serve not just as a diagnostic instrument but additionally as a reference whilst comparing the results of power new treatments.

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Extra resources for Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis: In Vivo Morphology in the Human Cornea

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The photographs of the right cornea were taken 18 days after the onset of symptoms. a b 18 days c Fig. 10 Eighteen days after symptom onset (Ad4). The findings resemble those shown in Fig. 9: (a) a lesion (white arrow) lacking defined edges and composed of light-reflecting spots (black arrow) and dots; (b) clumps of material (arrows) suggestive of cell debris; (c) individual rounded/abnormal cells (arrowheads) spread in an in-between area Comment Similarly to case 3, in a white eye showing coarse epithelial lesions (infiltrates) the patient’s history is important for differentiation between adenovirus and Thygeson’s keratitis.

The epithelium is heavily disturbed. It shows many rounded/abnormal cells (white arrowheads) and small cysts (black arrowheads); of these, many contain a rounded cell. ) a b 4 weeks c Fig. 14 (a–c) Four weeks after symptom onset, the epithelium shows (a and c) many rounded/abnormal cells, individual (white arrowheads) or grouped (arrows) and a cyst (black arrowhead). ) a 4 weeks b Fig. 14 showing rounded/abnormal cells (arrowheads); in the group indicated by arrow, the cells seem mixed with cell debris a b 7 months Fig.

Severe general symptoms are of serious concern to the parents (daughter in Case 3) and may even result 3 in hospital admission (Case 4); in the latter patient, the combination with red eye was an important diagnostic clue. Cases 3 and 5 show that coarse epithelial lesions in white eye, which is a typical feature of Thygeson’s keratitis, may be seen also in adenovirus-caused keratitis. The common error of diagnosing Thygeson’s keratitis as adenovirus is well known; one might wonder if also the converse might occur.

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