Red Eye - Exam 3 Flashcards
**_____ COPIOUS PURULENT DISCHARGE ; eyes can be “stuck shut” in the morning. can be ___ or ____. How is it transmitted?
CONJUNCTIVITIS
unilateral or bilateral
TRANSMITTED VIA DIRECT CONTACT
FINGERS, TOWELS, HANDKERCHIEFS, CONTAMINATED EYE DROPS
**_____ is the MC cause of conjunctivitis in adults. ____ in children. ____ who wear contacts.
Staph Aureus in adults
S Pneu in children
Pseudomonas in those who wear contacts
What is the treatment of choice for conjunctivitis in NONcontact lense wearers? For severe infection/contact lens use ______
erythromycin ophthalmic ointment or trimethoprim-polymyxin B drops (POLYTRIM)
TOPICAL FLUOROQUINOLONE
VIGAMOX OR MOXEZA (MOXIFLOXACIN)
OFLOXACIN OPHTHALMIC (OCUFLOX / FLOXIN)
CIPROFLOXACIN OPHTHALMIC
gonococcal infections in the eye are treated with _____. Chlamydial infections are treated with _____.
ROCEPHIN (CEFTRIAXONE) 1G IM – SINGLE DOSE can add ERYTHROMYCIN OR BACITRACIN
1G AZITHROMYCIN PO – SINGLE DOSE
**____ is the MC infectious cause of blindness (preventable blindness)
chlamydial
_____ pulls the eyelid inside out
Trachoma
USUALLY BILATERAL
COPIOUS WATERY DISCHARGE
FOREIGN BODY SENSATION
TYPICALLY LASTS 10 DAYS
ASSOCIATED WITH PHARYNGITIS, FEVER, MALAISE, PREAURICULAR ADENOPATHY aka flu like s/s
What am I?
What is the MC?
What is the treatment?
viral conjunctivitis
MC: adenovirus
supportive care: cold compress to reduce discomfort
pt education on hygiene
ITCHING
TEARING
REDNESS
STRINGY DISCHARGE
OCCASIONALLY PHOTOPHOBIA AND VISUAL LOSS
COBBLESTONE PAPILLAE NOTED ON EXAM
HYPEREMIA (bloodshot look to eye) AND CHEMOSIS (conjunctiva looks bulgy coming out of eye)
What am I?
**What are the 2 slum dunk characteristics?
Allergic conjunctivitis
**stringy discharge and cobblestone papillae
What is the treatment for mild-moderate allergic conjunctivitis? Severe?
TOPICAL ANTIHISTAMINES
ALAWAY (KETOTIFEN), PATANOL OR PATADAY (OLOPATADINE)
or
topical NSAIDS: diclofenac, ketorolac
severe: topical corticosteroids: LOTEPREDNOL (Alrex, Lotemax)
When would you NOT want to give steroids on a case of allergic conjunctivitis?
NO CORTICOSTEROIDS IF H/O OR SUSPECTED HSV
MAY CAUSE EXACERBATION
What does the uvea consist of?
the layer and structures of the eye beneath the sclera.
(1) the iris (and pupil)
(2) the ciliary body (secretes the aqueous humor)
(3) the choroid
the _____ is the layer of blood vessels and CT between the sclera and retina
choroid
Uveitis: anterior portion consists of ___ and ____.
The posterior portion consists of _____
Anterior portion:
Iris
Ciliary Body
Posterior portion:
Choriod
What are the different types of INTRAOCULAR INFLAMMATION OF THE UVEA? **What is the MC type?
ACUTE OR CHRONIC
NON-GRANULOMATOUS VS. GRANULOMATOUS
ANTERIOR OR POSTERIOR
ACUTE NONGRANULOMATOUS ANTERIOR UVEITIS
Describe a non-granulomatous uveitis. What is the predominant cell type?
Inflammation with no epithelial or giant cells
PRESENTS ACUTELY
UNILATERAL PAIN
REDNESS
PHOTOPHOBIA
VISUAL LOSS
PMN cells
Describe a granulomatous uveitis. What is the predominant cell type?
inflammation noted with histiocytes
INDOLENT
SLOW GROWING
BLURRED VISION
MILDLY INFLAMED EYE
RECURRENT
macrophages
What are some causes of acute NON-GRANULOMATOUS ANTERIOR?
ACUTE = PRIMARILY IMMUNOLOGIC aka autoimmune causes
HLA-B27 RELATED CONDITIONS
ANKYLOSING SPONDYLITIS
REACTIVE ARTHRITIS
PSORIASIS
ULCERATIVE COLITIS
CROHN’S DISEASE
What are some causes of chronic NON-GRANULOMATOUS ANTERIOR?
JUVENILE IDIOPATHIC ARTHRITIS
What are some causes of GRANULOMATOUS ANTERIOR uveitis?
SARCOIDOSIS
TOXOPLASMOSIS
TUBERCULOSIS
HIV
SYPHILIS
“SALT AND PEPPER” FUNDUS
HERPES
OCULAR TRAUMA
**“INFLAMMATORY CELLS AND FLARE” (proteins) WITHIN THE AQUEOUS is classic _____. How do you dx it? What will you see in severe cases?
anterior uveitis
slit lamp exam
SEVERE CASES = HYPOPYON
PUS IN THE ANTERIOR CHAMBER
In uveitis, CELLS MAY ALSO BE SEEN ON THE CORNEAL ENDOTHELIUM, what are they known as? in granulomatous you see _____. In non-granulomatous you seen _____
KERATIC PRECIPITATES (KPS) aka inflammatory cellular deposits
GRANULOMATOUS = LARGE KPS
IRIS NODULES MAY BE SEEN
NON GRANULOMATOUS = KPS ARE SMALLER
NO IRIS NODULES
in posterior uveitis, INFLAMMATORY LESIONS MAY BE PRESENT IN THE ____ or ____. What will new lesions look like? old lesions?
RETINA OR CHOROID
NEW LESIONS:
YELLOW WITH INDISTINCT MARGINS
RETINAL HEMORRHAGES
OLD LESIONS:
DEFINITE MARGINS
COMMONLY PIGMENTED
GRADUAL VISUAL LOSS—-SLOWER IN ONSET
MAY BE DUE TO VITREOUS HAZE AND OPACITIES
CAN PRESENT WITH FLOATERS AS WELL
BILATERAL INVOLVEMENT COMMON
What am I?
What is the cause?
posterior uveitis
idiopathic
autoimmune
pars planitis
infectious causes
What is pars planitis?
disease of the eye between the iris and choroid
What is the treatment for anterior uveitis?
refer to ophthalmology
**topical corticosteroids
dilation of the pupil to relieve discomfort: reduces painful spasms of ciliary muscles
What is the treatment for posterior uveitis?
systemic steroids
pupil dilation NOT needed
if infectious, treat with appropriate abx
______ is inflammation of the cornea. What are the different types?
keratitis
bacterial
viral
acanthomoeba
fungal
**____ are at the highest risk of developing bacterial keratitis. What is an additional cause? What is the MC pathogens?
contact lens wearers (especially those who wear them overnights)
corneal trauma
**PSEUDOMONAS
MORAXELLA
STAPHYLOCOCCI (INCLUDING MRSA)
STREPTOCOCCI
PT WILL COMPLAIN OF FOREIGN BODY SENSATION
TROUBLE KEEPING EYE OPEN
CORNEA APPEARS HAZY WITH ULCER AND ADJACENT STROMAL ABSCESS
HYPOPYON OFTEN PRESENT
What am I?
How do you dx?
What is the treatment?
bacterial keratitis
ULCER IS SCRAPED TO RECOVER MATERIAL FOR GRAM STAIN AND CULTURE
refer to ophthalmology
EMPIRICALLY WITH FLUOROQUINOLONES DROPS: OFLOXACIN 0.3%, CIPROFLOXACIN 0.5%, VIGAMOX, MOXEZA
HOURLY (DAY AND NIGHT) FOR THE FIRST 48 HOURS
Then tailor tx based on culture results
What are some causes of viral keratitis? Why is it dangerous?
PRIMARY OCULAR HERPES SIMPLEX-> can cause blindness
can cause blindness->TRAVELS TO SENSORY GANGLIA WHERE LATENCY DEVELOPS, VIRUS CAN COLONIZE THE TRIGEMINAL GANGLION
RED EYE
PHOTOPHOBIA
FOREIGN BODY SENSATION
WATERY DISCHARGE
REACTIVATED VIRUS ENTERS CELLS OF CORNEA
PRIMARY INFECTION MAY MANIFEST AS EYELID, CONJUNCTIVAL, AND CORNEAL ULCERATION
DENDRITIC (BRANCHING) CORNEAL ULCER
What am I?
What is the slam dunk s/s? How do you dx it?
Herpes simplex keratitis
**DENDRITIC (BRANCHING) CORNEAL ULCER
CORNEAL ULCERS IDENTIFIED WITH FLUORESCEIN STAIN
What is the treatment for HERPES SIMPLEX keratitis?
URGENT REFERRAL TO OPHTHALMOLOGIST
TOPICAL AND/OR ORAL ANTIVIRALS: treat until 1 week after lesions heals
ACYCLOVIR 400MG FIVE TIMES DAILY
ACYCLOVIR 3% OINTMENT
MALAISE
FEVER
HEADACHE
PERIORBITAL BURNING AND ITCHING
Rash
hutchinson sign
involves the OPHTHALMIC DIVISION OF THE TRIGEMINAL NERVE
What am I?
What is the tx?
HERPES ZOSTER OPHTHALMICUS
urgent referral to ophthalmology
HIGH DOSE ORAL ANTIVIRAL
ACYCLOVIR 800 MG FIVE TIMES A DAY
VALACYCLOVIR 1G TID
____ INVOLVEMENT OF THE TIP OF NOSE OR THE LID MARGINS PREDICTS INVOLVEMENT OF THE EYE
hutchinson sign
WHEN TREATING VIRAL KERATITIS, AVOID PRESCRIBING ____ . Why? What happens if you stop abruptly?
CORTICOSTEROIDS
IT CAN WORSEN OR PROLONG VIRAL INFECTION
CAUSE AN ACUTE REBOUND INFLAMMATORY REACTION
What are some causes of fungal keratitis?
AFTER CORNEAL INJURY WITH PLANT MATERIAL, OR IN AGRICULTURAL SETTING, AS WELL AS TRAUMA TO EYE
Name some common pt populations that you might see fungal keratitis?
AGRICULTURAL SETTING
UNDERLYING EYE DISEASE/IMMUNOCOMPROMISE
CONTACTS
MULTIPLE STROMAL ABSCESSES
LITTLE EPITHELIAL LOSS: corneal infiltrate feathery edges with “satellite lesions”
LITTLE EPITHELIAL LOSS: corneal infiltrate feathery edges with “satellite lesions”. Need to associate with ____. How do you dx? **What is the tx?
fungal keratitis
CORNEAL SCRAPING AND CULTURE FOR FUNGI
**NATAMYCIN 5%, AMPHOTERICIN 0.1-0.5%, VORICONAZOLE 1%
TREATMENT MAY LAST FOR 6 MONTHS
CAUSED BY SINGLE CELLED ______
FOUND IN RIVERS, LAKES, STREAMS, AIR, SOIL
COOLING SYSTEMS, SEWAGE SYSTEMS
OTHERWISE HEALTHY PEOPLE
CONTACT LENS WEARERS
USUALLY SEVERE PAIN: RARE BUT SERIOUS
swimming, sitting in hot tub, NOT washing hands before changing contacts
RED EYE
TEARING
BLURRED VISION
SENSITIVITY TO LIGHT
can proceed to vision loss
What am I?
Where does it like to invade?
How do you dx?
ACANTHAMOEBA KERATITIS
INFILTRATES IN THE CORNEAL STROMA likely invade THROUGH CORNEAL OPENING
DIAGNOSED WITH CULTURE USING SPECIALIZED MEDIA
What is the treatment for ACANTHAMOEBA keratitis?
TOPICAL BIGUANIDE (POLYHEXAMETHYLENE OR CHLORHEXIDINE) for 6 months to 1 year
WELL-CIRCUMSCRIBED AREA OF HEMORRHAGE UNDERNEATH CONJUNCTIVA
NORMAL VISUAL ACUITY
NORMAL PUPIL RESPONSE
What am I?
What is the cause?
What is the treatment?
SUBCONJUNCTIVAL HEMORRHAGE
VALSALVA, COUGHING, SNEEZING
SYSTEMIC HTN
ANTICOAGULANT MEDICATIONS
**self limiting: should reabsorb within 2 weeks
What is DACRYOADENITIS?
INFLAMMATION OR INFECTION WITHIN THE LACRIMAL GLAND
SWELLING, PAIN, REDNESS AT LACRIMAL GLAND
supratemporal region
What is DACRYOCYSTITIS? What is it due to?
INFECTION OF THE LACRIMAL SAC / DUCT
USUALLY DUE TO OBSTRUCTION OF THE NASOLACRIMAL SYSTEM (CONGENITAL OR ACQUIRED: INFANTS/PEOPLE OVER 40)
inframedial region
What does ACUTE DACRYOCYSTITIS
INFECTION PRESENT like? chronic?
Acute: PAIN, SWELLING, TENDERNESS, AND REDNESS IN TEAR SAC AREA
PURULENT MATERIAL MAY BE EXPRESSED
chronic: TEARING AND DISCHARGE
MAY HAVE SOME MUCUS OR PUS
What is the primary cause of DACRYOADENITIS?
inflammatory: autoimmune disease: Sjogren
viral: mumps
can be bacterial
**What are the causes of DACRYOCYSTITIS?
INFECTION IN LACRIMAL DUCT
generally d/t blocked tear duct
can be caused by organisms:
acute:STAPHYLOCOCCUS AUREUS
chronic: STAPHYLOCOCCUS EPIDERMIDIS
STREPTOCOCCI
**What is the treatment for autoimmune DACRYOADENITIS? viral? bacterial?
Autoimmune: Tx underlying cause/steroids
VIRAL: SUPPORTIVE CARE
Bacterial: SYSTEMIC ANTIBIOTICS
I&D IF NECESSARY
**What is the treatment for acute DACRYOCYSTITIS? What about is there is mucopurulent discharge WITHOUT other signs of infection? Purulent discharge WITH other signs of infection (erythema and/or swelling)
Lacrimal Sac Massage
without: topical abx: tobramycin sulfate 0.3% or moxifloxacin 0.5%
with: SYSTEMIC ANTIBIOTIC THERAPY: AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN)
What is the treatment for chronic dacryocystitis?
Sx: DACRYOCYSTORHINOSTOMY:
EXPLORATION OF LACRIMAL SAC AND FORMATION OF FISTULA INTO THE NASAL CAVITY
_____ CHRONIC INFLAMMATORY CONDITION OF THE LID MARGINS. Can be ____ or _____
BLEPHARITIS
anterior or posterior
**anterior blepharitis involves _____, _____ and ____. May be _____ or ______
EYELID SKIN
EYELASHES
ASSOCIATED GLANDS
ulcerative or seborrheic
What is anterior ulcerative blepharitis associated with? seborrheic?
ulcerative: STAPHYLOCOCCI
seborrheic: ITCHY RASH WITH FLAKY SCALES
posterior blepharitis is inflammation of the _____ AT INNER PORTION OF EYELID. Can be ____ or ____ or _____
MEIBOMIAN GLANDS
bacterial or PRIMARY GLANDULAR DYSFUNCTION or chronic skin conditions
_____ are MODIFIED SEBACEOUS GLANDS
RESPONSIBLE FOR EYE LUBRICATION
SECRETES OILY LAYER FOR TEARS
THIS HELPS TO REDUCE EVAPORATION OF TEARS
HELPS SPREAD TEARS
meibomian glands
What kind of blepharitis is “red rimmed” and scales are commonly seen in lashes?
anterior blepharitis
What kind of blepharitis are the lid margins red with spider veins (LID MARGINS ARE HYPEREMIC WITH TELANGIECTASIA), meibomian glands are inflamed, lid margin are rolled inward and tears may be frothy or abnormally greasy?
posterior blepharitis
RED, SWOLLEN, ITCHY EYELIDS
GRITTY OR BURNING SENSATION
RED EYES
EXCESSIVE TEARING (WHICH CAN BE A SIGN OF DRY EYE)
CRUSTING/MATTING OF EYELASHES IN THE MORNING
FLAKING OR SCALING OF THE EYELID SKIN
LIGHT SENSITIVITY
BLURRED VISION (TRANSIENT, USUALLY IMPROVES WITH BLINKING)
What am I?
What is the tx?
Blepharitis
anterior: good eye lid hygiene, wash with baby shampoo, can use BACITRACIN OR ERYTHROMYCIN (anti-staph) ointment with acute exacerbation
posterior: REGULAR MEIBOMIAN GLAND EXPRESSION
HOT WASH CLOTH WILL HELP WITH EXPRESSION
LID MASSAGE
If there is blepharitis with inflammation of conjunctivia and cornea, what is the tx?
LONG TERM LOW DOSE ORAL ABX THERAPY (2-4 WEEKS):
TETRACYCLINE 250 MG BID, DOXYCYCLINE 100MG DAILY, MINOCYCLINE 50-100 MG DAILY
and
SHORT TERM TOPICAL CORTICOSTEROIDS
PREDNISOLONE 0.125% BID
____ is an acute infection, that is localized, red, swollen and TENDER. can be on the upper or lower lid. What is the MC bacteria?
HORDEOLUM
STAPHYLOCOCCAL ABSCESS
An _____ is smaller and on the margin vs ____ is a meibomian gland abscess, USUALLY POINTS ONTO THE CONJUNCTIVAL SURFACE OF THE LID and MAY LEAD TO GENERALIZED CELLULITIS OF THE LID
EXTERNAL HORDEOLUM
INTERNAL HORDEOLUM
What is the tx for a HORDEOLUM?
WARM COMPRESS #1, massage and gentle wiping of the eyelid after compress may help with drainage
______ COMMON GRANULOMATOUS INFLAMMATION OF A MEIBOMIAN GLAND, HARD, NON-TENDER SWELLING,PAINLESS, LOCALIZED EYELID SWELLING
What is the tx?
chalazion
will resolve on its own
warm compress and massage/lid scrubs
if refractory: refer to ophthalmology INCISION AND CURETTAGE
CORTICOSTEROID INJECTION
What are the differences between a hordeolum and chalazion?
______ INFECTION OF THE SOFT TISSUE AND FAT THAT HOLD THE EYE IN ITS SOCKET. Who is the MC pt population?
ORBITAL CELLULITIS
children
What bacteria is the MC cause of orbital cellulitis? Where do most cases arise from?
STREP. PNEUMONIA, STAPH AUREUS (INCLUDING MRSA)
MOST CASES ARISE FROM EXTENSION OF ACUTE SINUSITIS THROUGH THE ETHMOID BONES
If orbital cellulitis is present in adults where did it arise from? hx of trauma or animal bite?
OFTEN CHRONIC SINUSITIS
ANAEROBIC ORGANISMS MAY BE INVOLVED
S AUREUS OR GROUP A B-HEMOLYTIC STREP
FEVER
PAIN
EYELID SWELLING AND ERYTHEMA, DECREASED VISION/DIPLOPIA
PROPTOSIS
PTOSIS
CHEMOSIS
PAIN WITH AND LIMITATION OF EXTRAOCULAR MOVEMENTS
SLUGGISH PUPILLARY REACTION TO LIGHT OR A RELATIVE AFFERENT PUPILLARY DEFECT INDICATES OPTIC NERVE INVOLVEMENT
double vision
decreased vision
RAPD
What am I?
Is it life threatening?
ORBITAL CELLULITIS
YES!!! can be sight and/or life threatening
**What 3 things make orbital cellulites an emergency?
PROPTOSIS
PTOSIS
PAIN WITH AND LIMITATION OF EXTRAOCULAR MOVEMENTS
**What is the immediate treatment for orbital cellulits? After improvement what abx regimen can you switch to?
immediate treatment with IV abx in the hospital
INITIAL EMPIRIC TREATMENT
IV VANCOMYCIN PLUS EITHER
CEFTRIAXONE OR CEFOTAXIME
IF ANAEROBIC COVERAGE IS NEEDED
POSSIBLY TOGETHER WITH METRONIDAZOLE OR CLINDAMYCIN
TRIMETHOPRIM - SULFAMETHOXAZOLE (BACTRIM)
PLUS AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN)
FLUOROQUINOLONE WITH PENICILLIN ALLERGY
_____ BACTERIAL INFECTION SUPERFICIAL TO THE ORBITAL SEPTUM, INFECTION OF THE ANTERIOR PORTION OF THE EYELID. What is is caused by? **What are the 2 MC organisms?
Preseptal cellulitis
HORDEOLUM
WOUND
ANIMAL BITE
CONJUNCTIVITIS
**STAPH. AUREUS AND STREP. PNEUMONIAE
TYPICALLY NO FEVER
+ EYELID SWELLING
+ ERYTHEMA
NO PROPTOSIS
NO LIMITATION OF OR PAIN WITH EXTRAOCULAR MOVEMENTS
NO VISION IMPAIRMENT/ DIPLOPIA
More common
What am I?
When should you order imaging?
Preseptal/periorbital cellulitis
IMAGING ONLY NEEDED WITH TREATMENT FAILURE OR UNSURE OF DIAGNOSIS
What is the treatment for preseptal cellulitis?
When do you need to send these pts to the hospital?
ORAL ANTIBIOTICS
AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN) OR CEFDINIR (OMNICEF) if PCN allergy
PLUS
TRIMETHOPRIM-SULFAMETHOXAZOLE or Clindamycin if sulfa allergy
IF NO IMPROVEMENT AFTER 24-48 HOURS ADMIT
What is the function of the cornea? If you have a corneal ulcer, what does it put you at a higher risk for? why?
CORNEA FUNCTIONS AS A PROTECTIVE BARRIER AND AS A “WINDOW” THROUGH WHICH LIGHT RAYS PASS TO THE RETINA
EPITHELIUM = BARRIER TO THE ENTRANCE OF MICROORGANISMS INTO THE CORNEA
IF EPITHELIUM IS DEFECTIVE = INFECTION DUE TO A VARIETY OF ORGANISMS
**What is a ciliary flush associated with? What is it?
corneal ulcer
PATHOGNOMONIC FOR CORNEAL PATHOLOGY
RED OR VIOLACEOUS RING SPREADING OUT FROM THE CORNEA
GRAY OR YELLOW INFILTRATE AT SITE OF BREAK IN CORNEAL EPITHELIUM
SEVERE PAIN
TENDS TO SPREAD RAPIDLY
BEGINS SUPERFICIAL BUT MAY QUICKLY AFFECT ENTIRE CORNEA
CORNEAL PERFORATION AND SEVERE INTRAOCULAR INFECTION
EXUDATE MAY HAVE BLUISH-GREEN COLOR
**What am I?
**What is the tx?
**What is the MC pt population?
How do you dx?
PSEUDOMONAS AERUGINOSA corneal ulcer
fluoroquinolones, aminoglycosides, cephalosporins, and carbapenems
MOXIFLOXACIN, GATIFLOXACIN, CIPROFLOXACIN, TOBRAMYCIN, OR GENTAMICI
CONTACT LENS WEARERS
SCRAPINGS FROM THE ULCER SHOW GRAM-NEGATIVE RODS
NO SPECIFIC IDENTIFYING FEATURES
SURROUNDING CORNEAL STROMA IS OFTEN INFILTRATED AND EDEMATOUS
MODERATELY LARGE HYPOPYON
**What am I?
**What is the tx?
**How do you dx?
GROUP A STREPTOCOCCUS corneal ulcer
ANTIBIOTIC EYE DROPS
MOXIFLOXACIN (VIGAMOX OR MOXEZA), GATIFLOXACIN, OR CEFAZOLIN
SCRAPINGS CONTAIN GRAM-POSITIVE COCCI IN CHAINS
HYPOPYON AND SOME SURROUNDING CORNEAL INFILTRATION
OFTEN SUPERFICIAL
ULCER BED FEELS FIRM WHEN SCRAPED
**What am I?
**What is the tx?
**How do you dx?
STAPHYLOCOCCUS AUREUS / STAPHYLOCOCCUS EPIDERMIDIS corneal ulcer
CEFAZOLIN, MOXIFLOXACIN, GATIFLOXACIN
MRSA
VANCOMYCIN
SCRAPINGS SHOW GRAM-POSITIVE COCCI – SINGLY, IN PAIRS, OR IN CHAINS
INDOLENT
GRAY INFILTRATE WITH IRREGULAR EDGES
MARKED INFLAMMATION OF THE GLOBE
SUPERFICIAL ULCERATION
SATELLITE LESIONS
**What am I?
**What is the tx?
**What organisms?
fungal corneal ulcer
AMPHOTERICIN B, VORICONAZOLE, POSACONAZOLE
CANDIDA, FUSARIUM, ASPERGILLUS, ETC
IRRITATION, PHOTOPHOBIA, TEARING, REDUCED VISION
HISTORY OF FEVER BLISTERS OR OTHER HERPETIC INFECTION
DENDRITIC ULCER IN THE CORNEAL EPITHELIUM
BRANCHING, LINEAR PATTERN WITH FEATHERY EDGES
TERMINAL BULBS AT ITS ENDS
What am I?
What is the slam dunk finding?
What is the tx?
Herpes simplex corneal ulcer
Dendritic ulcer in the corneal epithelium
ORAL ANTIVIRAL
ACYCLOVIR
TOPICAL ANTIVIRAL
IDOXURIDINE, GANCICLOVIR
_____ is the M/C CAUSE OF CORNEAL ULCERATION AND CORNEAL BLINDNESS
herpes simplex
