Healing signs in Infectious Keratitis

1) Symptoms start improving

•Less pain

•Less photophobia

•Less watering/discharge

•Less congestion

2) Ulcer margins become well defined

•An active ulcer typically has indistinct/hazy margins.

•A healing ulcer develops a clear line of demarcation around it, and the margin becomes smoother and better defined

•Margin and floor of the ulcer become more smooth and transparent

•Floor of ulcer is less necrotic, less sloughy and more transparent than before

3) The epithelial defect starts reducing in size

4) Stromal infiltrate becomes less dense and more organized

5) Surrounding corneal edema starts clearing

•In active ulcers, especially severe bacterial ulcers, the surrounding cornea can be hazy and edematous.

•As the ulcer heals, surrounding stromal edema reduces and corneal clarity improves around the lesion

•The borders become easier to define clinically

6) Superficial vascularization may appear

•This often indicates healing

•Once healing is complete, vessels may regress into ghost vessels

7) Hypopyon reduces

•If there was associated anterior chamber reaction:

•Hypopyon height decreases

•AC cells/flare reduce

•Fibrin reaction settles

8) Stroma starts scarring

•The ulcer transitions from an active infective lesion to a healed scar

Image from Rajan Eye Care Hospital

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