Which finding is most characteristic of EKC?

• A. Pseudomembranes
• B. Mild injection only
• C. Dry eye with tearing only
• D. Subconjunctival hemorrhage only

Answer: (A)

Pseudomembranes on the conjunctiva are the finding most characteristic of EKC. Epidemic keratoconjunctivitis, caused by adenovirus, often triggers a vigorous inflammatory response that forms fibrin-rich sheets—pseudomembranes—on the palpebral and bulbar conjunctiva. These membranes can peel away and may bleed, signaling a more severe, membrane-forming conjunctivitis typical of EKC. While mild injection or tearing without membranes can occur in other conditions, and subconjunctival hemorrhage can appear in various conjunctivitis, the presence of true conjunctival pseudomembranes best points to EKC. You may also encounter preauricular lymphadenopathy or later subepithelial corneal infiltrates, but the membrane formation is the hallmark feature.