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Corneal Defects, Abrasions and Foreign Bodies
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
In cases of mechanical trauma the mode of injury needs to be elicited from the history, remembering that high impact injuries carry a risk of penetrating globe damage. Abrasions are a one off event but the initial trauma (especially fingertip or sharp paper cut injuries) can lead to recurrent erosions, a syndrome whereby recurrent abrasions occur due to irregularity of healed epithelium and weakened adherence to its basement membrane. Recurrent corneal erosion syndrome can present many years after the initial trauma. Recurrent erosions occasionally occur in the presence of a corneal dystrophy, where irregularity of the epithelium, due to abnormal deposits in the cornea, are to blame. Patients usually experience intense pain, foreign body sensation and photophobia on waking, as the weak corneal epithelium is torn off as the eyelid opens up, having adhered to it as the cornea naturally dries overnight.
Chronic Hyperglycemia Impairs Vision, Hearing, and Sensory Function
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
The investigators reported an extensive review of publications on the damaging effect of diabetes on the cornea in the journal Nutrition and Diabetes (Shih, Lam, and Tong. 2017). Certain elements of their extensive findings stand out. For instance, the eyes of diabetes sufferers are at increased risk of dry eye, superficial punctate keratitis, recurrent corneal erosion syndrome, and persistent epithelial defects (Ye, and Lu. 2015; Achtsidis, Eleftheriadou, Kozanidou et al. 2014).
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
Lattice dystrophy is an autosomal dominant condition. The lesions typically involve the central cornea with clear intervening spaces. The periphery is spared. The condition usually presents as recurrent corneal erosion syndrome. Vision is usually normal until the 40s. The most common type of amyloid seen is amyloid P rather than amyloid A. Most cases of lattice dystrophy have amyloidosis confined to the cornea. It has a higher recurrent rate within the graft compared with other forms of stromal dystrophy.
Adaptations of early career optometrists in clinical practice during the COVID-19 pandemic
Published in Clinical and Experimental Optometry, 2021
Jack Phu, Kerry Ho, Suhyun Kweon, Nancy Liu, Lowana Littlechild, Daniel Rafla, Margaret Zhong
The risk of transmission of COVID-19 came with the need to reduce as much as possible extraneous points of human contact in ophthalmic practice.8 In particular, low risk patients who might have traditionally presented to their general practitioner or ophthalmologist might have been advised instead to see their primary care optometrist as a preferred first port of call. The concept of personalised medicine approaches in chronic disease care has been highlighted in an Australian context for glaucoma patients.9 An example of a co-managed case of recurrent multifocal choroiditis, a case of recurrent corneal erosion, and a case of acute allergic conjunctivitis managed during the pandemic using telehealth strategies is shown in Figure 2 (left).
Differentiating primary dry eye disease from ocular neuropathic pain: implications for symptom management
Published in Clinical and Experimental Optometry, 2023
Mark T Forristal, Kirk A J Stephenson
The prevalence of DED in hospital settings was similar to that in primary care, while neuropathic pain appeared more prevalent in primary care than in hospital settings though numbers recruited were low. While the prevalence of ONP is relatively unknown, our limited sample size suggests a neuropathic pain prevalence of 43% of DED presentations (n = 9). However, a much larger sample size would be required for an accurate estimate. Ocular trauma appeared to be a risk factor for DED and ONP, suggesting a role of recurrent corneal erosion syndrome in these presentations. Herpes Zoster Ophthalmicus history was present in 28.5% of neuropathic pain patients, indicating a potential relation of trigeminal neuralgia/tic doloreux with neuropathic pain symptoms.
Retroauricular myoperiosteal autograft for orbital implant exposure: 11 years of experience
Published in Orbit, 2020
Ramón Medel, Maria Vittoria Cicinelli, Johana Catalina Arboleda Hurtado, Juan Carlos Sánchez España, Alejandra Tapia Bahamondes, Luz María Vasquez
In one patient showing delayed re-epithelialization of the graft, autologous serum was prescribed to promote conjunctival growth. Topical autologous serum has been clinically used for the treatment of ocular surface disorders such as recurrent corneal erosion, persistent epithelial defects, superior limbic keratoconjunctivitis, and severe dry eye disease.21,22 Serum is thought to promote epithelial cell migration and anchorage, accelerating the epithelial repair process as it contains essential ocular surface nutrients, like cytokines, proteins, growth factors, lipids, vitamins, and bacteriostatic components.23 In our patient 8, this treatment was probably useful in enhancing conjunctival implant coverage at the last follow-up.