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Epidemic keratoconjunctivitis (EKC) is a keratitis caused by the highly infectious human mastadenovirus (HAdV) (1,2). Here, we report a case of EKC caused by HAdV type 54 (1–3) and resulting in extensive corneal epithelial defect. The case occurred 10 years after laserassisted in situ keratomileusis (LASIK) surgery. A 36-year-old man presented with pain in his right eye 10 years following uncomplicated LASIK procedures for myopia in both eyes at another hospital. All family members had contracted EKC from the man’s 2-yearold son, who was diagnosed by a local ophthalmologist using a rapid diagnostic test in early August 2015. On August 11 (day 1), the man noticed pain in his right eye. He visited a local ophthalmology clinic and was prescribed 0.5% levofloxacin and 0.1% fluorometholone eye drops. The pain gradually worsened, and an ocular infection was evident in his left eye on day 6; the man presented at Fukuoka University Hospital on day 7. On examination, the man had difficulty opening the right eye due to edema of the eyelid. The right eye had a severe ocular infection, and a conjunctival pseudomembrane was observed (Fig. 1A). The right cornea had a circular epithelial defect coinciding with the LASIK flap edge (Fig. 1B, C). The left eye also had an ocular infection, but no epithelial defect or subepithelial opacification was observed. Visual acuity was 20/20 (uncorrectable) in the right and 20/25 (corrected) in the left eye. Conjunctival scrapings of the right and left eyes were positive and negative, respectively, on immunochromatography testing (Capilia Adeno Eye, Tauns Laboratories Inc., Izunokuni, Japan). HAdV-54 was detected in the conjunctival scrapings of both eyes, using the method reported previously that is based on polymerase chain reaction amplification, sequencing, and phylogenetic analysis (4). Based on the clinical course, slit lamp examination findings, and laboratory test results, we diagnosed the man’s condition as EKC. The conjunctival pseudomembrane was removed, and the patient was treated with 0.1% betamethasone and 0.3% gatifloxacin eye drops.

A Case of Type 54 Human Mastadenovirus Keratoconjunctivitis Causing Severe Broad Epithelial Defect Ten Years after LASIK Surgery