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corneal ulcer (ulcerative keratitis)
Etiology:
- keratitis (see keratitis)
- bacterial infection
- herpes simplex
- contact lens
- trauma
Clinical manifestations:
- purulent discharge (image may not show this)
- prominent foreign body sensation
- excessive blinking & tearing
- eye pain
- visual impairment
- photophobia (MKSAP20)
- red eye
- corneal opacities
- hypopyon
* image of Pseudomonas aeruginosa corneal ulcer [5]
Special laboratory:
- ulcer can be seen with fluorescein dye
Complications:
- corneal ulcers can erode through the corneal stroma, exposing Descemet's membrane (descemetocele) & cause corneal perforation & permanent visual loss [3] Diffential diagnosis:
- episcleritis in not painful (MKSAP20)
- anterior uveitis causes pain, redness, hypopyon but is not associated with corneal opacities of corneal ulcer (MKSAP20)
Management:
- immediate referral to ophthalmology (see keratitis)
- antibiotic therapy
- corneal scraping
Comparative biology:
- see ref [4] for corneal ulcer in animals
- see Patient information for home management of corneal ulcer in dogs
Related
cornea (C, K)
General
corneal disease (keratopathy)
ulcer
References
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- eMedicine
http://www.emedicinehealth.com/corneal_ulcer/article_em.htm
- Medical Knowledge Self Assessment Program (MKSAP) 16, 18, 20.
American College of Physicians, Philadelphia 2012, 2018, 2025.
- Wikipedia: Corneal ulcers in animals
http://en.wikipedia.org/wiki/Corneal_ulcers_in_animals
- Morelli MK, Kloosterboer A, Omar AF
Pseudomonas aeruginosa Corneal Ulcer Associated With Artificial Tears Eye Drops.
JAMA Ophthalmol. 2023;141(5):496
PMID: 36947092
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2802949
- NEJM Knowledge+ Ophthalmology