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Corneal Ulcer/Keratitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
A corneal ulcer is an open sore on the cornea of the eye. Although there are many different causes, keratitis is frequently caused by a virus or bacterial infection. The cornea covers the iris and the round pupil. Symptoms can include red, watery, or itchy eye with a burning or stinging sensation, sensitivity to light, and a pus-like discharge. The infection can lead to loss of vision or blindness, and so requires immediate medical care.1
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Avoid complications, such as exposure keratitis: Occurs if the cornea is not adequately protected.Can be avoided by using artificial tears, instilling lubricating paraffin ointment, and taping (rather than padding) the eye closed at night.Dark glasses should be worn outdoors.Ophthalmological evaluation should be sought if the patient reports eye discomfort, or the eye becomes irritated despite the above measures.Botulinum toxin injection into the eyelid levator to weaken it may be considered if conservative measures fail.Tarsorrhaphy is rarely necessary in cooperative patients.Facial electrostimulation has not been shown to provide benefit.33
Ophthalmic Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Viral conjunctivitis, due to the adenovirus (‘pink eye’) or enterovirus, is highly contagious. Person-to-person spread is rapid unless scrupulous care is taken with hand hygiene and towel or face washer use. Give antibiotic drops and ointment to prevent secondary bacterial infection.Refer the patient to the next ophthalmology clinic for a definitive diagnosis and to monitor for the development of keratitis.
Therapeutic non-ectasia applications of cornea cross-linking
Published in Clinical and Experimental Optometry, 2023
Haitham Al-Mahrouqi, Isabella Mei Yan Cheung, Lize Angelo, Tzu-Ying Yu, Akilesh Gokul, Mohammed Ziaei
Infectious keratitis is most commonly caused by bacteria, and to a lesser extent by fungal, amoebic, or viral organisms.6 Contact lens wear, ocular trauma and ocular surface disease are among the leading predisposing factors.7 Infectious keratitis frequently leads to the development of corneal opacification and scarring and is one of the most common causes of blindness worldwide.8 At present, infectious keratitis is predominately managed by intensive topical antimicrobial regimens.7 However, in severe disease, complications including endophthalmitis, corneal perforation, and visual loss can still develop, despite prompt and definitive therapy.9,10 Furthermore, resistance of causative organisms to readily available antimicrobials could increase the potential of treatment failure.11 In an effort to address the above issues, alternative therapeutic approaches have been evaluated in recent years. One such treatment modality is Photoactivated Chromophore for Infectious Keratitis (PACK)-CXL.12 PACK-CXL denotes the application of CXL in infectious keratitis. As well as biomechanical stabilisation of the damaged cornea, UVA irradiation and photoactivated riboflavin also confer antimicrobial properties, hypothesised to occur via microbial DNA and RNA damage.13–17
Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2023
Paras P. Shah, Yoav Glidai, Richard Braunstein, Matthew Gorski, Jung Lee, Farihah Anwar, Amelia Schrier, Jules Winokur, Anne S. Steiner
Keratitis is an inflammatory condition of the cornea that can be characterized by pain, tearing, blurry vision, inflammation, and even loss of vision.17 Although its etiology is multifaceted, it is most commonly caused by infectious and non-infectious inflammatory conditions. Of these, infectious keratitis is the leading cause of corneal blindness and the fourth leading cause of overall blindness globally, representing an annual incidence of up to 799 per 100,000 population-year.5,18 Within the umbrella of infectious keratitis, HSV keratitis is the most common, affecting an estimated 500,000 people in the United States at any given time.19 Adequate work-up to identify the causative organism is crucial to guiding treatment; the gold standard remains culture, although other techniques such as in vivo confocal microscopy have also emerged.5
Kocuria Endophthalmitis: Clinical Spectrum and Long-term Outcomes
Published in Ocular Immunology and Inflammation, 2022
Gabriela P. Amadeo-Oreggioni, Grecia Y. Ortiz-Ramirez, Pablo Baquero-Ospina, Guillermo Salcedo-Villanueva, Jorge Jans Fromow-Guerra, Raul Velez-Montoya
The current case series expands the work by Dave et al and includes a detailed description of the clinical presentation and follow-up of 6 cases of Kocuria endophthalmitis.5 Although all patients were considered immunocompetent in our series, two patients had a history of longstanding diabetes mellitus, and all were significantly older than patients in the series by Dave et al at the time of endophthalmitis diagnosis (31 ± 17.4 vs. 60.5 ± 15.5).5 It is important to note that even though all patients reported severe pain, red eye, and poor visual acuity, the majority had keratitis-associated infections; therefore, this association should be taken with caution. Nevertheless, a more severe presentation than expected or a slightly longer time to onset should raise the suspicion level of Kocuria endophthalmitis in cases in which a CNS is the expected pathogen. This diagnosis should also be part of the differential diagnosis in cases of endophthalmitis associated with any form of keratitis, corneal ulcers, or penetrating keratoplasties.