Corneal ulcer: Difference between revisions

Revision as of 16:33, 5 October 2019

Corneal ulcer without infection

Major cause of impaired vision and blindness worldwide
Break in epithelial layer allows infectious agents to gain access to the underlying stroma
Risk factors include: incomplete lid closure (e.g. secondary to Bell's palsy) and soft contact lens use (especially sleeping in contacts)

Redness and swelling of lids and conjunctiva
Ocular pain or foreign body sensation
Decreased visual acuity (if located in central visual axis or uveal tract is inflamed)
Photophobia
Gray/white corneal lesion (will have fluorescein uptake)
Requires careful physical exam as 40% of lesions < 5mm
Hypopyon may be present
Iritis signs may be present (miotic pupil, consensual photophobia)

^Emergent diagnoses ^^Critical diagnoses

Emergent ophtho consultation
Topical antibiotics
- Vigamox 1 drop qhour OR
- Ciprofloxacin 1 drop qhour
Consider antiviral or antifungal if high suspicion for viral or fungal cause (rare)
Cycloplegic may help if iritis present
- Cyclopentolate 1%
Do not patch the eye

Authors:

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 *Major cause of impaired vision and blindness worldwide
 *Break in epithelial layer allows infectious agents to gain access to the underlying stroma
-*Risk factors include:  incomplete lid closure (e.g. secondary to [[Bell’s palsy]]) and soft [[contact lens]] use (especially sleeping in contacts)
+*Risk factors include:  incomplete lid closure (e.g. secondary to [[Bell's palsy]]) and soft [[contact lens]] use (especially sleeping in contacts)
 ===Causes===