corneal infiltrative events Flashcards
what is an infiltrate?
white blood cells in conreal tissue due to inflammatory response to bacterial toxins
what is a corneal ulcer?
epithelial defect with underlying inflammation
are corneal ulcers infective?
can be non-infective or infective
what are the 3 different ways to classify CIEs?
ulcerative vs non-ulcerative
suppurative vs non-suppurative
central vs peripheral keratitis
how does a corneal ulcer form?
too much colonising bacteria on the CL, causes build up of endotoxins, which are trapped between CL and epithelium, then go into the epithelium, which triggers WBC response
what is a disadvantage of describing a CIE as ulcerative vs non-ulcerative?
lack of agreement over definition of ‘ulcer’
what does suppurative mean?
produces discharge (pus)
what is a disadvantage of describing a CIE as suppurative vs non-suppurative?
not all MK cases have discharge
what is a disadvantage of describing a CIE as central vs peripheral?
not always reliable indicator of whether infiltrate is sterile or not
what are asymptomatic infiltrates?
infiltrates in patients without symptoms
are asymptomatic infiltrates only in CL wearers?
no - can be in non-CL wearers too
what are asymptomatic infiltrates usually caused by?
environmental factors e.g air pollution
signs of asymptomatic infiltrates?
1 or more small discrete grey-white patches usually in periphery
intraepithelial
formed from inflammatory cells
no other signs of inflammation
symptoms of asymptomatic infiltrates?
none you donut
management of asymptomatic infiltrates?
px lens care review
review is concern over compliance or a larger number of infiltrates
what does this image show?
asymptomatic infiltrates
signs of asymptomatic infiltrative keratitis (AIK)?
small focal infiltrates up to 0.4mm
sub-epithelial
may be small punctate staining
mild limbal and/or bulbar redness
how to differentiate between AIK and AI?
sub epithelial in AIK, intraepithelial in AI
-also size on infiltrates in AI (<0.2mm) and AIK (<0.4mm)
management of AIK?
review lens care
review fitting and advise against sleeping in lenses
symptoms of AIK?
NONE YOU FRESHY
what does this image show?
AIK
who is AIK more common in?
those wearing lenses for 12-14 hours +
or sleeping in lenses
what do you say to a px with AIK?
you have signs of an inflammatory reaction, this is common if you get build up of toxins on the lenses which usually occurs when we aren;t cleaning the lenses as much as needed …. then go on to talk about your management or whatever