Cornea

CORNEAL ABRASION and RECURRENT CORNEAL EROSION

Signs and Symptoms Corneal abrasion is one of the most common urgent clinical entities in practice.1-11 Patients present with some or all of the following: acute pain, photophobia, pain upon blinking and upon eye movement, lacrimation, blepharospasm, foreign body sensation, blurry vision and a history of contact lens wear or ocular trauma.2-11 Biomicroscopy of the…

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BACTERIAL KERATITIS

Signs and Symptoms A patient with bacterial keratitis will present with a typically unilateral, painful, photophobic, injected eye. Visual acuity may be reduced, and profuse tearing is common. There will be a focal stromal infiltrate with an overlying area of epithelial excavation. Often, there will be a history of contact lens wear, corneal trauma, or…

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SALZMANN’S NODULAR DEGENERATION

Signs and Symptoms Patients with Salzmann’s nodular degeneration are often asymptomatic, particularly in the early stages of the disease. Some may present with subjective glare, photophobia or diminished visual acuity if the nodules are situated on or near the visual axis.1,2 Nonspecific dry eye complaints such as burning, grittiness and foreign body sensation may also…

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FILAMENTARY KERATITIS

Signs and Symptoms Patients with filamentary keratitis typically present with variable reports of ocular discomfort, ranging from grittiness and mild foreign body sensation to pronounced pain. Tearing, photophobia and blepharospasm may accompany these symptoms in more severe cases.1 The condition may be unilateral or bilateral, depending upon the underlying etiology. Associated signs include ocular hyperemia,…

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MARGINAL KERATITIS

Signs and Symptoms Marginal keratitis is defined as a peripheral corneal inflammatory response.1-4 The condition is also known as sterile keratitis, infiltrative keratitis, peripheral keratitis, peripheral ulcerative keratitis, contact lens-induced peripheral ulcer (CLPU) and contact lens-related infiltrates. It can follow chronic exposure to an antigen (e.g., make-up, chemical exposure, pathogens), a chronic mechanical stimulus (e.g.,…

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TRAUMATIC CORNEAL LACERATION AND PERFORATION

Signs and Symptoms Traumatic corneal lacerations and perforations are invariably accompanied by a recent history of ocular injury. Typically, this involves a sharp object such as a knife, hand tool, tree branch or glass shard, although cases have been documented involving some very obscure items, including fish hooks, plastic toys, ninja stars and the talons…

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MOOREN’S ULCER

Signs and Symptoms Mooren’s ulcer represents an idiopathic, inflammatory, marginal or peripheral ulceration of the cornea. There are two recognized presentations, which were initially described by Wood and Kaufman in 1971.1 The first of these is the typical or benign type, which tends to be unilateral, mild to moderate with regard to symptoms, and more…

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HERPES SIMPLEX VIRUS EPITHELIAL KERATITIS

Signs and Symptoms The herpes simplex virus (HSV) is a common pathogen in developed regions of the world and a frequent source of ocular infection. Nearly 60% of the American population is seropositive for HSV-1 and another 17% is seropositive for HSV-2.1 Initial ocular infection by HSV tends to be seen in younger patients, with…

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FUCHS’ ENDOTHELIAL CORNEAL DYSTROPHY

Signs and Symptoms First described by Austrian ophthal-mologist Ernst Fuchs in 1910, the endothelial disorder that bears his name is a bilateral—though often asymmetric—condition, and relatively common in older adults.1,2 While it may occasionally be diagnosed earlier based upon biomicroscopic findings, Fuchs’ dystrophy is rarely symptomatic before 50 years of age. Patients typically present with…

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GRANULAR DYSTROPHY

Signs and Symptoms Granular corneal dystrophy is a bilateral condition that affects the central regions of the corneal stroma while sparing the periphery.1-3 Two distinct classifications of this condition have been described: type 1 (GCD1), or classic granular dystrophy and type 2 (GCD2), more commonly known as Avellino corneal dystrophy.1,4 Clinically, both varieties present with…

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