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Corneal ulcer, also called keratitis, is an inflammatory or, more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. [ 1 ] [ 2 ] [ 3 ] It is a common condition in humans particularly in the tropics and in farming. [ 4 ]
Peripheral Ulcerative Keratitis (PUK) is a group of destructive inflammatory diseases involving the peripheral cornea in human eyes. [1] The symptoms of PUK include pain, redness of the eyeball, photophobia, and decreased vision accompanied by distinctive signs of crescent-shaped damage of the cornea.
Keratitis is a condition in which the eye's cornea, the clear dome on the front surface of the eye, becomes inflamed. [1] The condition is often marked by moderate to intense pain and usually involves any of the following symptoms: pain, impaired eyesight, photophobia (light sensitivity), red eye and a 'gritty' sensation. [2]
This classic herpetic lesion consists of a linear branching corneal ulcer (dendritic ulcer). During eye exam the defect is examined after staining with fluorescein dye. The underlying cornea has minimal inflammation. Patients with epithelial keratitis complain of foreign-body sensation, light sensitivity, redness and blurred vision.
Symptoms may be noted to persist after contact lenses are removed, or following antibiotic treatment. [citation needed] Signs: The eyelids and adnexa involved shows edema and redness, conjunctiva is chemosed. Ulcer may be present. It is a dry looking corneal ulcer with satellite lesions in the surrounding cornea.
However, no single therapy has been found to eliminate both trophozoite and cystic forms, and to eradicate corneal infection. [4] [15] [12] One class of medications used in treatment is the biguanides, which include polyhexamethylene biguanide (PHMB) 0.02% to 0.06% drops, and chlorhexidine 0.02 to 0.2% drops.
Ulcerative vernal keratitis require surgical treatment in the form of debridement, superficial keratectomy, excimer laser therapeutic keratectomy, as well as amniotic membrane transplantation to enhance re-epithelialisation. Recently treatment with tacrolimus ointment (0.1%) used topically twice daily is showing encouraging results.
Neurotrophic keratitis (NK) is a degenerative disease of the cornea caused by damage of the trigeminal nerve, [1] which results in impairment of corneal sensitivity, spontaneous corneal epithelium breakdown, poor corneal healing and development of corneal ulceration, melting and perforation. [2]