Ocul Disease-Cornea1

-superificial lesion, hallmark of viral disease, granular opalescent swollen epithelial cells, visible without stain

• -superficial lesion
• -endothelial decompensation, acute IOP elevation, loss of corneal lustre, vescicles and bullae (maybe)

• -superficial lesions, mucus strangs lined with epithelium
• -stains with rose bengal
• -assocatied with keratoconjunctivitis sicca, superior limbic keratoconjunctivitis, recurrent erosion

-superficial lesions, inflammatory or degenerative sub-epithelial ingrowth of fibrovascular tissure from the limbus

• -punctate keratitis
• -epithelial edema
• -filaments
• -pannus

• -sign of stromal lesion in cornea
• -focal area of active stromal inflammation (accumulation of leucocytes and cell debris), caused by non-infectious or infectious keratitis

• -infiltrates (non-infectious, infectious)
• -edema (keratoconus, Fuch's dystrophy, surgery)
• -vascularization

• -breaks (corneal enlargement, birth trauma, keratoconus) -> AH influx into cornea
• -folds (surgical trauma, ocular hyptony (low P-> cornea collapse), stromal inflammation, edema)

• measure thickness of cornea with ultrasound
• >0.6 corneal thickness centrally suggests endothelial disease

• -suppress inflammation
• -limit scarring
• -may suppress corneal repair
• -contraindicated with HSV epithelial disease

• 1. lubrication
• 2. bandage soft CLs
• 3. eyelid closure

• 1. antimicrobial agent
• 2. topical steroid
• 3. systemic immunosupressives

• -small, non-staining peripheral infiltrate with minimal anterior chamber reaction
• -fluoroquinoline q 2-4h (and tobramycin for CL wearer)

• -med size peripheral infiltrae with epithelial defect adn lid AC reaction or moderate discharge
• -fluoroquinolone q1h around the clock

• -fortified antibiotics
• -intensive fluoroquinolone therapy

• -infection of cornea (due to hypoxia and/or epithelial break)  by replicating microbes -> excavation of epithelium, bowman's, stroma, infiltration and necrosis
• -often Pseudomonas aeruginosa (bacterial keratitis and white spot on cornea and red eye)

• -photophobia, pain, blurred vision, eyelid edema, dicharge
• -injection
• -infiltrate
• -stromal edema
• -hypopyon
• -corneal perforamtion, endophthalmitis

• -stop wearing CL
• -NO patching
• -oral painkillers
• -cycloplegic agent (to prevent posterior synechiae, increase Pt comfort)
• -if Pseudomonas, then use fluoroquinolones (vigamox) and fortified antibiotics
• -culture if unresponsive

• -stromal necrosis and AC affected
• -Aspergillus, Fusariu, Candida due to trauma with organic material
• -filamentous keratitis: greyish, satellite lesions, fuzzy, plaque, hypopyon
• -candida keratitis: yellow-white ulcer, dense

• -in air, soil, water, pools, hot tubs, poor hygiene, tap water
• -CL wearers
• -radial perineurititis, anterior stromal infiltrates, scattered dendritic-like appearance, PAIN
• -cycloplege, Brolene, PHMB, polymyxin (neosporin), systemic antifungal (ketoconazole)

• -adenoviral infrection (type 8 and 19) leading to acute, self-resolving follicular conjunctivitis that can spread to cornea (SPK, infiltrates) and cause an acute stromal response
• -pallative (artificial tears, cool compresses, vasoconstrictor/antihistamine, steroids (for stromal involvement)

• -HSV, a DNA virus,  that spreads through direct contact (cold sores) is dormant in trigeminal
• -minor fever, corneal lesion (50%), unilateral red eye, pain, photophobia
• -stain with rose bengal- see dendritic ulcer, scattered punctate epitheliopathy

• -antiotiobic oinment for skin lesions (bid, erythromycin, bacitracin), cool soaks (tid)
• -corneal epithelial disaes: trifluridine antiviral (viroptic), cycloplegic (if AC rxn present), oral antiviral (acyclovir)

• -infection caused by human herpes virus 3, dormant in dorsal root ganglia
• -skin rash, Hutchinson's sign (tip of nose = nasociliary nerve and high change of ocular involvement)
• -unilateral headache, blurred vision, red eye, corenal sensation reduced, pseudodendritic epithelial infiltrates

• -antibacterials: bacitracin or erythromycin oinment (skin lesions)
• -oral antivirals: acyclovir (w/i 72 hrs of rash onset)
• -antificial tears for corneal pseudodendrites
• -monitor raised IOP and uveitis (cells and flare)