Among 15 patients with epidemic Keratoconjunctivitis (EKC) due to adenovirus type 8, two had persistent corneal erosions during acute disease, nine had inflammatory membranes formation, and seven developed conjunctival scarring. Electron microscopy revealed adenovirus-like particles in the conjunctiva of one patient and in the corneal epithelium of another. This finding supports the hypothesis that late corneal opacities of EKC are initiated by virus infection of corneal epithelium. Since these corneal opacities are suppressed by topically applied corticosteroid they are probably inflammatory in nature. While conjunctival membranes and scarring were manifestations of severe disease, there was no evidence that the scars resulted from organization of the membranes. The mechanisms by which adenovirus type 8 produces these severe clinical manifestations are unknown, but both the host's immune response and possible virus toxins should be considered.
Dawson CR, Hanna L, Togni B. Adenovirus Type 8 Infections in the United States: IV. Observations on the Pathogenesis of Lesions in Severe Eye Disease. Arch Ophthalmol. 1972;87(3):258–268. doi:10.1001/archopht.1972.01000020260005
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