Objective 5b Corneal Opacities

Question 1

Evaluation Procedure: Corneal abrasion

Answer 1

S: Pain, redness, tearing, some photophobia
O: Foreign material scratching the corneal epithelium leaving the corneal nerves exposed. Fluorescene Staining
A: record
P: Remove cause, cease contact lens wear, refer if necessary

Question 2

Evaluation Procedure: Epithelial Edema (rare)

Answer 2

S:Colored halos around lights, photophobia, decreased vision
O: Hazy cornea when viewed with sclerotic scatter or retroillumination. Occures with ecposure to hypotonic solutions, reflex tearing, or during adaptation to low oxygen transmision lenses.
A: record
P: refer, cease contact lens wear

Question 3

Evaluation Procedure: Stromal Edema

Answer 3

S:
O: Stromal folds and striae, localized edema will be visable as hazy grey region of cornea
A: record
P: reduce wearing time

Question 4

Evaluation Procedure: Superficial Punctate Keratitis (SPK)

Answer 4

S: Foreign body in the eye, tearing, photosensitivity
O: Fine scattered areas of loss of corneal epithelial cells, leasions are slightly elevated and usually look like tiny grey pinpoints on the epithelial layer of the cornea
A: record
P: cease wear of contact lenses

Question 5

Evaluation Procedure: Micro cysts

Answer 5

S: May be mild irritiation or hazing of vision (due to chronic hypoxia a small number of microcyst in CL wearers is normal)
O: Show reversed illumination in marginal retro illumination
A: record
P: Reduce wear, change to higher oxygen lens.

Question 6

Evaluation Procedure: Striae

Answer 6

S: Glare sensitivity in some cases or asymptomatic
O: Straie appear as fine white verticale lines, which tend NOT to branch, in the posteriour stroma
A: record
P: Reduce wearing time

Question 7

Evaluation Procedure: Corneal Neovascularization

Answer 7

S: None (vision may be affected in deep stromal vasculardazition due to the associated opacities
O: ingrowth of vessels in the cornea due to chronic corneal hypoxia
A: record
P: Consider SiHy or GP lenses

Question 8

Evaluation Procedure: Corneal Ulcer

Answer 8

S: Foreign body sensation, redness, mild photophobia, symptoms reduce with lens removal
O: Distinctive, circular infiltrateon cornea, clearly defined margins, epithelial staining, small scar that fades over time
A: record
P: Discontinue wear immediately, refer, review after treated.

Question 9

Evaluation Procedure: dellen

Answer 9

S: None or dryness and discomfort
O: local saucer-like depression in the peripheral cornea ocures in the 3 and 9 o’clock, Staining in GP wear.
A: record
P: Reduce wear or refit with soft lenses , rewetting drops