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Corneal Ulcers and Contact Lens Keratitis
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Adequate history and careful examination of the anterior segment of the eye is crucial, which will help identify if it is infectious or not and the risk factors or aetiology. Infectious corneal ulcers can be caused by bacteria, virus, fungi or acanthamoeba, and in some cases concurrent microbes may exist. Common non- infectious corneal ulcers include marginal keratitis, peripheral ulcerative keratitis (PUK), sterile corneal infiltrates associated with contact lens wear and toxic keratitis (contact lenses/solution or eye drops for example).
Cornea
Published in Mostafa Khalil, Omar Kouli, The Duke Elder Exam of Ophthalmology, 2019
Mostafa Khalil, Omar Kouli, Rizwan Malik
Peripheral ulcerative keratitis (PUK) is a group of conditions that leads to peripheral corneal thinning. The most common systemic association is rheumatoid arthritis. Other associations include polyarteritis nodosa, Wegener granulomatosis and relapsing polychondritis.
Unusual Corneal Sarcoidosis Manifestations
Published in Ocular Immunology and Inflammation, 2023
Andrea Córdoba, Luis F. Mejía, Natalia González, Juan C. Gil
Peripheral ulcerative keratitis usually occurs due to infectious and immunologic causes, and is common in patients with rheumatoid arthritis; its pathophysiology usually involves the deposition of immune complexes with microangiitis at the level of the limbar vascular arcade.7 Currently, there are only two case reports of PUK in patients with sarcoidosis as underlying systemic disease; however, the pathophysiological connection between these two conditions is not entirely clear since systemic vasculitis has been described in patients with sarcoidosis, but it is infrequent.4,5 Moreover, PUK is more uncommon in patients with sarcoidosis than other pathologies frequently associated with systemic vasculitic processes such as rheumatoid arthritis and granulomatosis with polyangiitis. PUK was the primary ocular manifestation of the disease in our patient, showing multiple inflammatory reactivations both nasal and temporal and requiring medical and surgical management. Biopsies of the resected conjunctiva in the conjunctival recessions performed failed to demonstrate the presence of active vasculitis.
Ocular Involvement in Systemic Lupus Erythematosus: The Experience of Two Tertiary Referral Centers
Published in Ocular Immunology and Inflammation, 2018
Rosanna Dammacco, Pasquale Procaccio, Vito Racanelli, Angelo Vacca, Franco Dammacco
It is considered the most frequent ocular manifestation of SLE and is usually associated with secondary Sjögren’s syndrome9,12,25,26 (SSS). In this study, none of the patients had a primary Sjögren’s syndrome (SS) according to the 2016 ACR/European League Against Rheumatism classification criteria,27 whereas SSS of variable severity was diagnosed in 11 patients, 7 of whom also had additional ocular manifestations. Besides dry mouth, frequent joint stiffness and sometimes swollen salivary glands, consistently bilateral ocular symptoms included ocular pain, burning, or gritty sensation that patients often described like sand in their eyes, redness, blurred vision, and itch along rima palpebrarum. Peripheral ulcerative keratitis and scarring were detected by slit-lamp examination in two patients, and refractory filamentary keratitis in two patients, all of them with high SLEDAI.
Clinical Profile of Patients with Necrotizing Scleritis in a Tertiary Eye Care Center in Southern India
Published in Ocular Immunology and Inflammation, 2018
Parthopratim Dutta Majumder, Avirupa Ghose, Meenakshi Chidambaram, Sudha K. Ganesh, Jyotirmay Biswas
The current study included 31 eyes of 27 patients, of which eight (29.6%) were women and 19 (70.4%) were men. The mean age of the patients in the study was 49.5 years (range: 22–85 years). The mean duration of follow-up was 380.34 days (180–700 days). A total of 23 patients (85.2%) had unilateral presentation to begin with, while four patients (14.8%) developed bilateral necrotizing scleritis. The duration of symptoms and signs was variable, on average 276.39 ± 98.96 days (20–700 days). The most common presenting symptom was ocular pain (96.7%) followed by redness (83.8%). Corneal involvement in the form of peripheral ulcerative keratitis, was observed in nine eyes (29%). Six eyes (19.35%) showed anterior uveitis. Fundus examination revealed exudative detachment in three eyes (9.6%) and vitreous hemorrhage in one eye (3.22%), which was secondary to diabetic retinopathy. Demographic and clinical characteristics of all patients included in the current study are summarized in Table 1.