Look closely at the periphery!

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 2,4,8 and 10 o’clock positions⁣ ● 1-2 mm parallel to the limbus⁣ ● Clear margin between infiltrates and limbus⁣ ● Can lead to formation of marginal ulcer⁣ ● Findings of blepharitis present⁣ ⁣ ● Course : Subepithelial infiltrates separated by clear zone → Spreads circumferentially → Bridging vascularisation → Resolution⁣ ⁣ Management :⁣ ⁣ ● Topical steroids⁣ ● Treatment of associated blepharitis⁣ ⁣ www.ophthalmobytes.com⁣ ⁣ Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #marginalkeratitis #keratitis #cornea #cornealulcer #staphylococcus #blepharitis

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