Eye: Keratitis, Corneal Ulcers , Leukoma

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Keratitis

  • Is an inflammation or infection of the cornea that can be caused by a variety of microorganisms.
  • When it involves conjunctiva & cornea it is termed as kerato-conjuctivitis.
Bacterial infections
  • Epithelial layer can get disrupted & cornea can become infected by a variety of bacteria.
  • Risk factors include mechanical or chemical corneal epithelial damage, contact lens wear, debilitation, nutritional deficiencies, immuno suppressed states & contaminated products
  • Topical or subconjunctival antibiotics are generally effective, if severe IV antibiotics are used.

Viral infections
  • Herpes simplex virus keratitis is most common viral infection of the cornea
  • Pain & photophobia may appear
  • Therapy- corneal debridement
  • Topical therapy with vidarabine or trifluridine is beneficial   
  • Oral acyclovir

Keratoconjunctivitis is the most serious ocular adenoviral disease.
  • Spread by direct contact, including sexual activity
  • Patient may complain of tearing, redness, photophobia & foreign body sensation.
  • Treatment is with topical corticoSteroids & antibiotic ointment   Teaching about good hygienic practices

Corneal ulcer
  • Tissue loss caused by infection of the cornea produces a corneal ulcer (infectious keratitis)
  • Infection can be due to bacteria, fungi & viruses.
  • Painful & patient may feel a foreign body in the eye, tearing , purulent or watery discharge, redness & photophobia
  • Treatment-antibiotic, antiviral or other antifungal eye drops.
  • Untreated corneal ulcer can result in corneal scarring & perforation

Leukoma
  • Means opacity of the cornea affecting. small area or whole of the cornea.
Causes
  • Healed corneal ulcer   
  • Healed keratitis
  • Penetrative or operative injury to the cornea
  • Foreign bodies or corneal dystrophy
Symptoms
  • No symptoms if the opacity is outside the pupillary area
  • Visual disturbances — if it is in the pupillary area
Management
  • Small, does not hamper the vision- no treatment required.
  • If hampers vision-
  • Keratoplasty/ corneal grafting
  • Optical iridectomy- pupillary area is extended to periphery by making a complete iridectomy followed by cosmetic surgery


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notes.nursium.com: Eye: Keratitis, Corneal Ulcers , Leukoma
Eye: Keratitis, Corneal Ulcers , Leukoma
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