Corneal ulcer: Difference between revisions
No edit summary |
No edit summary |
||
Line 1: | Line 1: | ||
==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== | ==Diagnosis== | ||
# Gray/white | #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 | |||
[[Category:Ophtho]] | [[Category:Ophtho]] |
Revision as of 02:09, 26 October 2011
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