-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, pneumococcal). -Chemosis. -Papillae. DIAGNOSIS: • Scrape the ulcer from the ulcer edge and base. Send for: • Gram’s stain. • Giemsa stain. • Acid fast stains. • Blood and chocolate agar. - 10% KOH (to rule out a fungal element). TREATMENT: MEDICAL: • Topical antibiotics (either monotherapy or combination therapy - fortified antibiotics) along with cycloplegics and anti-glaucoma drops WHEN DO WE ADD SYSTEMIC ANTIBIOTICS? • Severe keratitis with scleral melting. • Impending perforations and frank perforations. SURGICAL: -Tissue adhesives. -Patch grafts. -TPK. www.ophthalmobytes.com Image from Rajan Eye Care Hospital #ophthalmology #cornea #ophthalmobytes#ophthal #doctor #health #medical #vision #education#optometry #medicalstudent #optometrist#medicine #eye #ophtho #ophthalmologist#ophthalmo #med #medicaleducation#ophthalmologyresident#ophthalmologyresidency #apaoyo #keratitis#bacterialkeratitis #ulcer #cornealulcer #cornea#bacterialulcer