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Blepharitis
- Etiology: Staphylococcus
- Bilateral
- History of recurrent hordeoli
- Collarettes, madarosis
- Inferior corneal pannus
- Dry eye
- Marginal infiltrates, ulcers, phylectenules, old scars
Chicken Pox
- Etiology: Varicella
- Typically childhood presentation
- Bilateral ocular involvement with scalp and trunk vesicles
- Papillary conjunctivitis and lid lesions
- Treatment: Supportive
Resolving Corneal Abrasions
- History of trauma
- Foreign body sensation to severe pain
- Unilateral
- Healing pattern in a pseudo-dendritic pattern
- Treatment: Antibiotic, cycloplegic, +/-bandage lens
Recurrent Epithelial Erosions
- Morning pain
- Possible past history of trauma
- Unilateral
- Intrapalpebral location common
- Underlying anterior basement membrane dystrophies
- Treatment: Similar to corneal abrasion with the addition of hypertonic solution or ointment. Consider superficial keratectomy in recurrent cases.
Inclusion Conjunctivitis
- Etiology: Chlamydia
- Young, sexually active adults
- Mucopurulent discharge
- Micropannus, subepithelial infiltrates, punctate keratitis
- Predominantly a follicular conjunctivitis
- May involve limbus
- Culture positive
- Treatment: 1gm dose Azythromycin
Thygeson Keratitis
- White eye with foreign body sensation, photophobia, and tearing
- Bilateral but asymmetric
- Random punctate keratitis with subepithelial opacities
- No conjunctivitis
- Recurrent
- Treatment: topical steroid
Epithelial Splits Secondary to Soft Contact Lenses
- Soft contact lens wearer
- Few symptoms: Minor irritation, injection
- Unilateral
- Superior cornea, circumferential linear lesion
- Treatment: Remove and refit contact lens
Acanthamoeba Keratitis
- Contact lens wearer
- Poor contact lens hygiene
- Acute with rapid progression: severe pain, decreased vision
- Varied stellate or dendriform epithelial and subepithelial irregularities
- Disciform edema, ring-shaped stromal infiltrate
- 70%-80% originally diagnosed as herpetic infection
- Treatment: referral to corneal subspecialist
- Principal Management
- Antimicrobial therapy
- Topical steroids
- Topical cycloplegics: 5% homatropine
- Control pain with oral nonsteroidal anti-inflammatory agents
- Penetrating keratoplasty
Go to: Viral Keratoconjunctivitis CE table of contents
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