Corneal ulcer: Difference between revisions
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==Background== | ==Background== | ||
[[File:Corneal ulcer.jpg|thumb|Corneal ulcer without infection]] | |||
*Major cause of impaired vision and blindness worldwide | *Major cause of impaired vision and blindness worldwide | ||
*Break in epithelial layer allows infectious agents to gain access to the underlying stroma | *Break in epithelial layer allows infectious agents to gain access to the underlying stroma |
Revision as of 13:36, 29 July 2014
Background
- Major cause of impaired vision and blindness worldwide
- Break in epithelial layer allows infectious agents to gain access to the underlying stroma
Clinical Features
- Redness and swelling of lids and conjunctivae
- Ocular pain or foreign body sensation
- Decreased visual acuity (if located in central visual axis or uveal tract is inflamed)
Diagnosis
- Slit-Lamp Exam
- Gray/white lesion
- Hypopyon may be present
- Iritis signs may be present:
- Miotic pupil
- Consenual photophobia
DDX
- Bacteria
- Pseudomonas
- Strep pneumo
- Staph
- Moraxella
- Viruses
- Herpes simplex
- Varicella zoster
- Fungi
- Candida
- Aspergillus
- Penicillium
- Cephalosporium
Treatment
- Emergent ophtho consultation
- Topical abx
- Ciprofloxacin or ofloxacin otic, 1 drop qhr in affected eye
- Antiviral or anti-fungal if high suspicion for viral or fungal cause
- Cycloplegic
- Helps w/ pain from accompanying iritis
- Cyclopentolate 1%
- Do not patch the eye
Disposition
Refer to ophtho within 12-24hr
Complications
- Corneal scarring
- Corneal perforation
- Ant/posterior synechiae
- Glaucoma
- Cataracts
Source
Tintinalli