corneal perforation

Question 1

causes of corneal perforation?

Answer 1

infectious (bacterial, viral, fungal, parasite like acanthomoeba form contact lens)

non infectious: contact lens, steroid use, corneal abrasion, foreign body

Question 2

symptoms?

Answer 2

eye pain, redness, photophobia, blurry vision

corneal opacity

Question 3

diagnosis?

Answer 3

slit lamp with fluorescein dye: ulcer will pick up dye
if leak: means perforation
if dendritic lesions: HSV1 infection
keratic precipitates, hypopyon

Question 4

complications:

Answer 4

corneal perforation, vision loss, corneal scarring

Question 5

investigations and management

Answer 5

swab, gram stain and culture
start empiric ABs (third generation) until swab is -ve / switch to specific ABs for organism

use chlorhexidin if acanthamoeba
use atropine drops for mydriasis (dilate) to relieve pain and prevent complications

if HSV= acyclovir