4 - Opth - Acute red eye - Keratitis

Question 1

what is keratitis

Answer 1

corneal inflammation usually due to infection

Question 2

What is corneal abrasion

Answer 2

epithelial breach due to trauma - risk of infection - chloramphenicol prophylaxis

Question 3

Bacterial keratitis - usually when?

Answer 3

following corneal abrasion or prolonged contact lens wear

Question 4

Bacterial keratitis - presentation - SIGNS

Answer 4

epithelial defect appears green with flourescein
white cell infiltrate
may be hypopyon

Question 5

Presentation of bacterial keratitis

Answer 5

circumcorneal/diffuse redness
pain/FBody sensation
photophobia
discharge
REDUCED VA

Question 6

MGMT bacterial keratitis

Answer 6

topical AB’s

cycloplegia and analgesia for pain

Question 7

Viral keratitis - which viruses

Answer 7

HSV (usually 1) or Varicella zoster

Question 8

Other types of keratitis?

Answer 8

Fungal –> RF’s - trauma, immuno-suppression

signs - grey elevated infiltrate with feathery edges +/- satellite lesions +/- epithelial defect

Question 9

Presentation of HSV keratitis

Answer 9

pain, photophobia, redness, reduced VA

-decreased corneal sensation, superficial dendritic ulcers

Question 10

MGMT of HSV keratitis

Answer 10

antivirals (aciclovir), cycloplegia, analgesia

DO NOT use steroids - rapid progression of infection

Question 11

MGMT of VZV keratitis

Answer 11

pain, photphobia, redness, reduced VA, Neuralgia, macular papular rash, ulceration and keratitis in ~65%

Question 12

Complications of VZV keratitis

Answer 12

posterior uveitis, optic neuropathy, CN palsies, uveitic glaucoma

Question 13

MGMT of VZV keratitis

Answer 13

systemic antivirals, lubricating eye drops, +/- topical corticosteroids