corneal injury

Question 1

what is corneal abrasion?

Answer 1

Corneal abrasions refer to any defect of the corneal epithelium and most commonly come about from a recent history of local trauma (e.g. fingernails, branches).

Question 2

features of corneal abrasion?

Answer 2

eye pain
lacrimation
photophobia
foreign body sensation and conjunctival injection
decreased visual acuity in the affected eye

Question 3

ix for corneal abrasion?

Answer 3

fluorescein staining
examination typically reveals a yellow-stained abrasion (representative of the de-epithelialized surface) which is usually visible to the naked eye
visualisation is enhanced by the use of a cobalt blue filter (available on an ophthalmoscope) or a Wood’s lamp

Question 4

mx for corneal abraision?

Answer 4

a topical antibiotic is recommended for these patients in order to prevent secondary bacterial infection.

Question 5

features of corneal foreign body?

Answer 5

eye pain
foreign body sensation
photophobia
watering eye
red eye

Question 6

when to refer for corneal foreign body?

Answer 6

Suspected penetrating eye injury due to high-velocity injuries (e.g. drilling, lawn moving or hammering) or sharp objects (e.g. as glass, knives, pencils or thorns)
Significant orbital or peri-ocular trauma has occurred.
A chemical injury has occurred (irrigate for 20-30 mins before referring)
Foreign bodies composed of organic material (such as seeds, soil) should be referred to ophthalmology as these are associated with a higher risk of infection and complications
Foreign bodies in or near the centre of the cornea
Any red flags e.g. severe pain; irregular, dilated or non-reactive pupils; significant reduction in visual acuity.

Question 7

what is corneal ulcer?

Answer 7

A corneal ulcer describes a defect in the cornea, typically secondary to an infective cause. The term corneal abrasion is typically used for corneal defects secondary to physical trauma.

Question 8

RF for corneal ulcer?

Answer 8

contact lens use
vitamin A deficiency: a particular problem in the developing world

Question 9

pathophysiology of corneal ulcer?

Answer 9

bacterial keratitis
fungal keratitis
viral keratitis: herpes simplex, herpes zoster - may lead to a dendritic ulcer
Acanthamoeba keratitis: associated with contact lens use

Question 10

features of corneal ulcer?

Answer 10

eye pain
photophobia
watering of the eye
focal fluorescein staining of the cornea