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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 ]
[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]
It is a dry looking corneal ulcer with satellite lesions in the surrounding cornea. Usually associated with fungal ulcer is hypopyon , which is mostly white fluffy in appearance. Rarely, it may extend to the posterior segment to cause endophthalmitis in later stages, leading to the destruction of the eye.
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.
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.
The cornea lacks blood vessels and is among the most densely innervated structures of the human body. Corneal nerves are responsible for maintaining the anatomical and functional integrity of the cornea, conveying tactile, temperature and pain sensations, playing a role in the blink reflex, in wound healing and in the production and secretion of tears.
Lagophthalmos, the inability to close the eyelids completely is the main cause of exposure keratopathy.Common cause of lagophthalmos is facial nerve (CN VII) palsy. Facial nerve function may affect in several conditions like cerebrovascular accident, head trauma, brain tumors, Bell's palsy etc. Physiological inability to close the eyelids during sleep (nocturnal lagophthalmos) may also cause ...
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.