Ulcers Flashcards
What are the 4 layers of the cornea?
Epithelium
Stroma
Descemet’s Membrane
Endothelium (produce the decemet’s membrane)
How do you diagnose a superficial corneal ulcer and why does this work on a molecular level?
Flurosene dye: the epithelium is hydrophobic but the stroma is hydrophilic so dye sticks to it
List two exogenous causes of corneal ulcers? Endogenous?
Ex: FB, Trauma
En: eyelid abnormality like ectopic celia or entropion
How do we treat a simple ulcer? What should we never treat with any why?
Antibiotic drops, prevent further trauma (ie cone), atropine drops (pain relief and dilates pupils to reduce any anterior uveitis signs).
Steroid drops: cause melting ulcer
Howl long does a simple ulcer take to heal?
7 days maximum
What makes a corneal ulcer complicated? 5 reasons:
- Into the stroma layer
- Quite deep
- Infected
- Melting
- Persist longer than 1 week
What do we call an ulcer that has reached decemet’s membrane?
Desmetocoele
How is complicated ulcer treatment different to simple ulcer treatment?
Aggressive higher tier topical antibiotics needed
Non-steroidal given (oral only)
Atropine twice daily (pain relief and prevent reflex uveitis)
Prevent further trauma
May require specialist reconstruction
Two specialist reconstruction methods?
Conjunctiva flap over ulcer
Corneal flap over ulcer (good as can view progress more easily)
What is classed as an indolent ulcer?
Fail to heal after 7 days with no stromal loss. The epithelium does not adhere to stroma below
How do we diagnose an indolent corneal ulcer?
Fluorescence stain giving a hazy look
How do we treat indolent ulcers?
Anestheneitize eye and debride then grid keratotomy
What 3 things make up tears and what cells make them?
Lipid mebomian
Aqueous: lacrimal and third eyelid
Mucin: goblet
What drugs can cause dry eye?
TMS and sulfasalzine
What drugs can cause dry eye?
TMS and sulfasalzine
