Eyeworld

N EWS 18 | EYEWORLD | AUGUST 2019 Contact information Toy: brian.toy@med.usc.edu by Maxine Lipner EyeWorld Senior Contributing Writer RESEARCH HIGHLIGHT Treatment for measles conjunctivitis and keratitis involves supportive care, such as making sure that there's no breakdown of the corneal epithelium, which can lead to secondary infection of the cornea and cause scarring, Dr. Toy said. This means keeping the eyes lubri- cated with artificial tears or ointments. If the epithelium does break down, patients should be started on antibiotic ointments, ensuring good lid closure and treating other comorbid condi- tions (such as vitamin A deficiency) that could exacerbate the infection. More severe complications, measles retinopathy and optic neuritis, can go hand in hand with the infection. "The classic findings are a diffuse retinitis and profound vision loss within 6 to 12 days after onset of the classic presentation of measles. A pigmentary retinop- athy develops as the acute infections resolves, described as a salt and pepper fundus," Dr. Toy A lthough the Centers for Disease Control and Prevention proclaimed that measles had been eliminated from the U.S. in 2000, this past year they reported more than 1,000 cases nationwide, according to Brian Toy, MD. These cases are not limited to the purview of internists, since measles can have ocular ramifications. "The classic presentation of measles in- cludes the 3 Cs: cough, coryza, and conjunctivi- tis," Dr. Toy said, adding that measles is spread by aerosolized particles, which infect mucous membranes. That triad of symptoms presents with fever a week or two after initial infection with the virus. In general, physicians today may not be familiar with measles, Dr. Toy said. If a patient presents with conjunctivitis together with a cough, runny nose, then a fever, it's important to be mindful that it could be a case of measles, he stressed. Visual consequences of measles About the doctor Brian Toy, MD Assistant professor of clinical ophthalmology USC Roski Eye Institute Keck School of Medicine University of Southern California Los Angeles Financial interests Toy: None continued on page 20

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