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[11] [14] [9] Corneal transplantation is a management option when there is severe corneal melting or perforation although one possible disadvantage is the risk of rejection. [14] Surgical treatment helps maintain the integrity of the globe, but it is usually complementary because it alone cannot influence the underlying immunological process. [7]
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 ]
In the United States, Acanthamoeba keratitis is nearly always associated with soft contact lens use. [7] Acanthamoeba spp. is most commonly introduced to the eye by contact lenses that have been exposed to the organism through the use of contaminated lens solution, using homemade saline-based solution or tap water, or from wearing contact lenses while bathing or swimming.
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.
An oral tetracycline antibiotic (such as doxycycline) may be used in systemic or particularly severe/intractable infections. [2] [4] Erythromycin may be an effective alternative, especially in pediatric cases where the side effects of tetracyclines are unacceptable. [4] Artificial tears can reduce dryness and discomfort from corneal lesions. [2]
It is also used for the treatment of multidrug-resistant tuberculosis. [10] It is used by injection into a vein using an IV or into a muscle. [9] Amikacin, like other aminoglycoside antibiotics, can cause hearing loss, balance problems, and kidney problems. [9] Other side effects include paralysis, resulting in the inability to breathe. [9]
More significant injuries like a corneal ulcer, globe rupture, recurrent erosion syndrome, and a foreign body within the eye should be ruled out. [1] Prevention includes the use of eye protection. [1] Treatment is typically with antibiotic ointment. [1] In those who wear contact lenses a fluoroquinolone antibiotic is often recommended. [1]
Treatment of large papillae- Cryo application, surgical excision or supratarsal application of long-acting steroids. General measures include use of dark goggles to prevent photophobia, cold compresses and ice pack for soothing effects, change of place from hot to cold areas. Desensitization has also been tried without much rewarding results.