Infective Keratitis (1)

Question 1

What is this?

What is the most common cause?

What are the other causes?

Answer 1

➊ Inflammation of the cornea due to infection

➋ HSV

➌ * Bacterial – Pseudomonas or Staphylococcus
* Fungal – Candida or Aspergillus
* Exposure Keratitis – Inadequate eyelid coverage e.g. ectropion

N.B. Pseudomonas is the most common cause in contact lens wearers.

Question 2

How does it present?

What may be seen O/E?

Answer 2

➊ • Painful red eye
• Photophobia
• Dendritic corneal ulcer – branching and spreading of the ulcer
• Watery (Viral) or Sticky (Bacterial)

➋ • Reduced visual acuity
• Hypopyon if bacterial

Question 3

Investigations:
What’s a key test to do here?

What else should be done?

Answer 3

➊ Fluorescein staining - Will show dendritic corneal ulcer (stains green in areas that have lost epithelium i.e. ulcers)

➋ • Slit-lamp examination
• Corneal swab/scrape for culture

Question 4

How is it managed?

Answer 4

• Viral - Aciclovir or Ganciclovir
• Bacterial - Ciprofloxacin
• Corneal transplant may be required after the infection has resolved to treat any scarring