Corneal abrasion and erosions

Question 1

Corneal abrasion sympotoms

Answer 1

prev trauma - FB

RB sensation -

pain - deep into epithelium or corneal nerve

photophobia

tearing

blepharospasm - pain will increase on blink

reduced vision depandant on location (i.e central)

Question 2

Corneal abrasion signs

Answer 2

corneal defect - Grade

greish areas on slit lamp where epithelium has started to bunch and reform plug

Fluroscein staining present

small abrasion can become larger if px is deficient in hemidesolome (epi can peel away)

Question 3

Corneal abrasion management

Answer 3

dependant on extent

nothing if superficial- artificial tears

systemic pain releif and chloramphenicol

follow up - depends on extent - may see 2 days later if large just to make sure epithelium has regenerated properly

Question 4

corneal abrasion healing process

Answer 4

6 hours- episode cellls start to migerate, epithelial plug

24-48 hours - defect filled with epi cells (no staining)

72-96 hours - cells start attaching to deeper layers

3/12 - attachment fully formed, hemadozomes are what keep epic cells attached.

Question 5

Recurrent erosions

Answer 5

liked to abrasions

poor attachment of epithelium to desements membrane - dure to dystrophies or trauma

px deficient in hemidesmosomes - scrach can cause epi to peel away

lids stick to epi at night

epi tore away upon waking - painful, usually px wakes up with sore eyes.

Question 6

recurrent erosions symptoms

Answer 6

pain - esp in morning

photophobia - corneal nerves exposed

lacrimation on walking due to air resistance upon walking

Question 7

recurrent erosions signs

Answer 7

epithelial disturbance

fluroscein staining

gray area around epi defect site

Question 8

recurrent erosions management

Answer 8

lubrication at day and night (3/12) - thicker ointment at night

dry eye drops (carbommer)

cycloplegia

antibiotics

cyclopentonol 1% 2x daily

referral - Hes will use alcohol to remove all epi cells to allow for equall healing