corneal ulcers

Question 1

baseline tests for a suspected corneal ulcer

Answer 1

FL-
shirmer tear test

Question 2

chronic nonhealing ulcer that has no underling cause. what do you suspect? how to confirm?

Answer 2

sus: SCCED. confirm by numbing the eye and taking a swab to see if the epithelium comes up
or KCS: do shirmer tear test

Question 3

what doesnt SCCED ulcers heal normally

Answer 3

the epithelium does not adhere to the cornea

Question 4

treatment for SCCED

Answer 4

epithelial debridement, the grid keratotomy.
abx TID
+- 3rd eyelid flap
+- contact lens

Question 5

acute ulcer treatment

Answer 5

topical Abx BID/TID
atropine SID/BID
+- NSAIDS, artificial tears

recheck q24hr

Question 6

midstromal ulcer treatment

Answer 6

aggressive treatment. up frequency for abx, antiinflammatories

add systemic tetracyclines
+- gaba for pain
+- C/S

Question 7

desmetocele treatment

Answer 7

surgical treatment. very fragile. do not want to rupture the cornea.

conjunctival flap
corneoconjunctival transpostition

Question 8

general ulcer healing time if normal

Answer 8

7-10 days at most.

Question 9

general goals for ulcer treatment

Answer 9

prevent and control infection and collagenolysis

increase comfort and promote healing

Question 10

you treat an ulcer and at 10 days it is not healed. why

Answer 10

entropion
distichea
ectopic cilia
FB
SCCED