Infective Keratitis Flashcards
1
Q
What is Infective Keratitis?
A
Inflammation of the cornea.
2
Q
Give 5 causes of Keratitis.
A
- Viral e.g. HSV (commonest).
- Bacterial e.g. Staphylococcus (main), Pseudomonas (Contact-Lens).
- Fungal e.g. Candida, Aspergillus.
- CLARE - Contact Lens Acute Red Eye.
- Exposure Keratitis i.e. Inadequate Eyelid Coverage e.g. Eyelid Ectropion.
3
Q
Pathophysiology of Viral Keratitis (3).
A
- Usually - Epithelial Layer of Cornea.
- If there is inflammation. of stroma (layer between epithelium and endothelium) - stromal keratitis.
- Reactivation of HSV-Type I (dormant in trigeminal ganglion).
4
Q
Pathognomonic Feature of Viral Keratitis.
A
Dendritic Corneal Ulcer.
5
Q
What complications is Stromal Keratitis associated with? (5).
A
- Stromal Necrosis.
- Vascularisation.
- Scarring and Perforation.
- Corneal Blindness.
- Endophthalmitis.
6
Q
Amoebic Keratitis (3).
A
- Acanthamoebic Keratitis.
- 5% of cases.
- Increased incidence with eye exposure to soil or contaminated water.
7
Q
Give 2 triggers for bacterial keratitis.
A
- Corneal abrasion.
2. Contact lens use.
8
Q
Clinical Features of Keratitis (6).
A
- Painful Red Eye.
- Photophobia.
- Vesicles around Eye.
- Foreign Body (Gritty) Sensation.
- Lacrimation.
- Reduced Visual Acuity.
9
Q
Investigations of Keratitis (4).
A
- Anyone who presents with red eye with a suspected potentially sight-threatening cause should be referred for same-day assessment by an ophthalmologist.
- Diagnosis - Slit-Lamp Examination.
- Stain with Fluorescein - Dendritic (Branching) Corneal Ulcer.
- Corneal Swabs/Scrapings - Isolate Virus (Viral Culture/PCR).
10
Q
Secondary Care Management of Keratitis (6).
A
- Antivirals - Aciclovir, Gnaciclovir.2. Topical Steroids (maybe) in Stromal Keratitis.
- Corneal Transplant (after resolution, if corneal scarring).
- Don’t wear contact lens.
- Bacterial - Quinolones.
- Analgesia- Cyclopegic Medications.
