Corneal ulcer: Difference between revisions
m (Rossdonaldson1 moved page Corneal Ulcer to Corneal ulcer) |
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*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 | ||
===Causes=== | |||
*[[Bacteria]] | |||
**[[Pseudomonas]] | |||
**[[Strep pneumo]] | |||
**[[Staph]] | |||
**[[Moraxella]] | |||
*[[Viruses]] | |||
**[[Herpes simplex]] | |||
**[[Varicella zoster]] | |||
*[[Fungi]] | |||
**[[Candida]] | |||
**[[Aspergillus]] | |||
**[[Penicillium]] | |||
**[[Cephalosporium]] | |||
==Clinical Features== | ==Clinical Features== | ||
| Line 8: | Line 23: | ||
*Ocular pain or foreign body sensation | *Ocular pain or foreign body sensation | ||
*Decreased visual acuity (if located in central visual axis or uveal tract is inflamed) | *Decreased visual acuity (if located in central visual axis or uveal tract is inflamed) | ||
==Differential Diagnosis== | |||
==Diagnosis== | ==Diagnosis== | ||
*[[Slit-lamp exam]] | |||
**Gray/white lesion | |||
**Hypopyon may be present | |||
**Iritis signs may be present: | |||
***Miotic pupil | |||
***Consenual photophobia | |||
==Treatment== | ==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== | ==Disposition== | ||
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==Complications== | ==Complications== | ||
*Corneal scarring | |||
*Corneal perforation | |||
*Ant/posterior synechiae | |||
*Glaucoma | |||
*Cataracts | |||
== | ==References== | ||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
Revision as of 13:18, 24 May 2015
Background
- Major cause of impaired vision and blindness worldwide
- Break in epithelial layer allows infectious agents to gain access to the underlying stroma
Causes
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)
Differential Diagnosis
Diagnosis
- Slit-lamp exam
- Gray/white lesion
- Hypopyon may be present
- Iritis signs may be present:
- Miotic pupil
- Consenual photophobia
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