OPHTHALMOBYTES

-Symptoms are usually more than signs. RISK FACTORS: OCULAR FACTORS • Trauma. • Ocular surface disorders. • Contact lens wear • Drugs (Corticosteroids) SYSTEMIC FACTORS • Diabetes mellitus, HIV positive patients (immunocompromised states). SLIT LAMP EXAMINATION: -An epithelial defect with surrounding stromal infiltration which is usually different for different organisms. -Suppurative stromal infiltration. -Associated conjunctivitis is certain organisms (gonococcal, pne

𝘍𝘶𝘯𝘨𝘢𝘭 𝘜𝘭𝘤𝘦𝘳- 𝘋𝘪𝘢𝘨𝘯𝘰𝘴𝘪𝘴 𝘢𝘯𝘥 𝘔𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵⁣ ⁣ The picture shows a KOH mount showing filamentous septate hyphae ⁣ ⁣ 𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀:⁣ ● Corneal scraping- both diagnostic and therapeutic⁣ ● AC tap⁣ ● Corneal biopsy⁣ ● PCR⁣ ● Confocal microscopy ⁣ ⁣ 𝗦𝘁𝗮𝗶𝗻𝘀 𝘂𝘀𝗲𝗱:⁣ ● KOH mount with Calcoflour white⁣ ● Gram’s stain⁣ ● Giemsa stain⁣ ● Lactophenol cotton blue⁣ ● PAS stain⁣ ● Grocott’s Methenamine-silver stain⁣ ⁣ 𝗙𝘂𝗻𝗴𝗮𝗹 𝗰𝘂𝗹𝘁𝘂𝗿𝗲:⁣

Fungal ulcer is caused by organisms:⁣ ● Nonpigmented Filamentous septate: Fusarium, Aspergillus⁣ ● Pigmented Filamentous septate: Alternaria, Curvularia⁣ ● Filamentous Non-septate: Mucor⁣ ● Yeasts: Candida⁣ ⁣ 𝘙𝘪𝘴𝘬 𝘍𝘢𝘤𝘵𝘰𝘳𝘴:⁣ 𝗢𝗰𝘂𝗹𝗮𝗿 𝗳𝗮𝗰𝘁𝗼𝗿𝘀:⁣ ● Trauma (with vegetative or organic matter)⁣ ● Chronic corneal inflammation - due to vernal or allergic keratoconjunc tivitis and⁣ neurotrophic ulcers secondary to varicella zoster or herpes simplex viruses ocular

𝐌𝐨𝐨𝐫𝐞𝐧’𝐬 𝐔𝐥𝐜𝐞𝐫 𝐌𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭⁣⁣⁣ ⁣⁣⁣ 𝐒𝐭𝐞𝐩𝐰𝐢𝐬𝐞 𝐀𝐩𝐩𝐫𝐨𝐚𝐜𝐡⁣⁣⁣ ⁣⁣⁣ The goal of therapy is to ​arrest the destructive process and to promote healing and reepithelialization of the corneal surface⁣⁣⁣ ⁣⁣⁣ 1. 𝘛𝘰𝘱𝘪𝘤𝘢𝘭 𝘤𝘰𝘳𝘵𝘪𝘤𝘰𝘴𝘵𝘦𝘳𝘰𝘪𝘥𝘴 to control the inflammation⁣⁣⁣ ⁣⁣⁣ 2. 𝘊𝘰𝘯𝘫𝘶𝘯𝘤𝘵𝘪𝘷𝘢𝘭 𝘳𝘦𝘴𝘦𝘤𝘵𝘪𝘰𝘯⁣⁣⁣ ● Conjunctiva adjacent to the ulcer contains inflammatory cells that may be producing antibodies against the cornea

𝐌𝐨𝐨𝐫𝐞𝐧’𝐬 𝐔𝐥𝐜𝐞𝐫⁣⁣⁣ ⁣⁣⁣ ● Mooren’s is a chronic, progressive and painful peripheral ulcerative keratitis of idiopathic/unknown etiology and no systemic associations.⁣⁣⁣ ● First described by Boman and McKenzie in 1854 as ‘chronic serpiginous ulcer/ ulcus rodens’⁣⁣⁣ ● Autoimmune process - a Type 3 hypersensitivity reaction has been implicated - antigen antibody reaction to infectious toxin deposited in the peripheral cornea causes inflammation and ulceration⁣⁣⁣ ● More

Marginal Keratitis⁣ ⁣ ● Hypersensitivity reaction due to Staphylococcus Aureus exotoxins in the peripheral cornea⁣ ⁣ ● Patients have associated Staphylococcal blepharitis/ conjunctivitis ⁣ ⁣ Mechanism:⁣ ⁣ ● Type III Hypersensitivity⁣ ⁣ ● Antigen-antibody complexes deposited in peripheral cornea → complement pathway activated and neutrophil attraction → peripheral stromal infiltrates → epithelial breakdown and ulceration⁣ ⁣ Signs :⁣ ⁣ ● Subepithelial- Stromal infiltrates at 2,