Ngozi couldn't open her eyes in sunlight and was missing work. She had been given antibiotic drops that were making no difference. Mascot Healthcare tested for the viral cause, stopped the antibiotics, and managed her through the natural resolution with protective care.
Banker. Presented with severe bilateral eye pain, photophobia (light sensitivity), profuse watery discharge, eyelid swelling, and reduced vision — developing 7 days after attending a crowded outdoor event. Rapid adenovirus test positive.
Epidemic Keratoconjunctivitis (Adenoviral)The outbreak at the outdoor event had been significant — several of Ngozi's colleagues who attended also developed eye symptoms. She had gone to a pharmacy three days after symptom onset and been given chloramphenicol eye drops. After 4 days of drops — 16 doses, applied conscientiously — her eyes were worse, not better.
She came to Mascot Healthcare wearing sunglasses indoors. The doctor performed a rapid adenovirus antigen test from a conjunctival swab. The result was positive in 10 minutes.
"This is a viral infection," the doctor explained. "The antibiotic drops won't work because viruses don't respond to antibiotics. Your eyes need to fight this off — we can make that process more comfortable and protect your cornea, but you can't take a pill that kills this virus."
Epidemic keratoconjunctivitis (EKC) is caused by adenovirus — the same family responsible for the "Apollo" eye epidemics in West Africa. It is highly contagious, self-limiting, and not improved by antibiotics.
Intense eye pain with severe light sensitivity — requiring dark rooms and sunglasses indoors.
Large volume of clear watery discharge — different from the purulent discharge of bacterial conjunctivitis.
Significant periorbital oedema — both eyelids swollen and red.
A palpable, tender lymph node in front of the ear — classic in viral conjunctivitis.
Blurred vision from corneal involvement (keratitis) — subepithelial infiltrates on slit-lamp examination.
Chloramphenicol 0.5% eye drops 4 times daily × 4 days — appropriate for bacterial conjunctivitis; no antiviral activity.
Her previous eye drops were stopped. Supportive treatment: lubricating eye drops (artificial tears) hourly for comfort; cold compresses to reduce eyelid swelling; prescription eye drops for the corneal changes (to prevent long-term corneal haze); sunglasses outdoors.
Infection control: Ngozi was told to take 1 week off work (she was in a customer-facing role); no touching eyes; no shared pillowcases or towels; wash hands after any eye contact; her household contacts were warned.
She was told: this typically lasts 2–4 weeks and peaks in the first 2 weeks. Corneal infiltrates may take longer to resolve and can cause temporary haze — re-examination in 2 weeks was arranged.
Epidemic Keratoconjunctivitis — adenoviral (rapid antigen test positive; bilateral, watery, preauricular node, corneal involvement)
Stop previous eye drops; lubricating drops hourly; cold compresses; prescription drops for corneal infiltrates; sunglasses; 1-week work absence; household hygiene protocol
At 2 weeks: discharge and pain resolved; photophobia improved; mild residual corneal haze. At 6 weeks: cornea fully clear.
Full recovery within 6 weeks. Corneal infiltrates resolved completely — no long-term visual sequelae. No household transmission after implementing the hygiene protocol.
Adenoviral keratoconjunctivitis ("Apollo") is viral and does not respond to antibiotic eye drops. Identifying it early (with a rapid test) stops unnecessary antibiotic use and triggers the correct management: isolation, comfort, and corneal protection.
The highly contagious nature means strict infection control is as important as the treatment itself — one uncontrolled case spreads to multiple household and workplace contacts.
Red eyes with watery discharge, light sensitivity, and a swollen pre-ear lymph node is adenoviral — not bacterial. Antibiotic drops won't help.
Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.