3-CORNEAL3.PPT

7/25/2019 3-CORNEAL3.PPT

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KERATITISKERATITIS

H. IZAR AZIZ


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Dr.H.Izar Aziz,SpM( 2

Function of the cornea :Function of the cornea :

as Window of the globe & refractive media: clear & transarent with ower ! "# $% as microorganisms barrier


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oss of transarenc' caused by:endothelial damageeithelial damage.


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Eithelium covered b' tear film :as a barriermicroorganisms infection % (e)cet

*% +onorrhoea, $escemet-s membrane as barrier for bacterial

infection to ./A %(but not for fungus,

Etiology of keratitis : Exogenous : bacteria ,fungus , virus,

parasite

Endogenous : allergic reaction.


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Fungus(usuall' oortunistic, .andida3 Fusarium3 Asergillus

9irus

9S 99;

2arasite : Acanthamoeba

in Contact lens user


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Secial e)aminations

!lourescein test for corneal ulcer "eidel test for perforating cornea


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aborator' Studies

#tiologic diagnosis."craping frominfiltrate / edge of the ulcerfornices of conyunctiva

"lide "taining$ram ( for bacteria)$iemsa (for fungus )


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12

.linical course

"ubepithelial /epithelial%eratitis

Recover

without scar

Become

corneal ulcer

&ecover'ith scar

ebula

a%ula*eu%oma

+erforating cornea,accompanied bulging of the

cornea iris prolaps

&ecover 'ith scar *eu%oma adherentstaphyloma cornea

.orneal blindness

dvancedinflamation

-endophtalmitis-panophtalmitis

rec!erE)tirationof the globe

bulbi

"#$%sis &'&i

Permanent blindness


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.linical aearance of corneal ulcers

Sereginous corneal ulcer% Etiolog' : 2neumococcus acute3 well circumscribed

gra' ulcer3 tends to sread to center of cornea

h'o'on is common (sterile,


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2seudomonas ulcer.Etiolog' : 2seudomonas aerg% (resent in Flourescein

sol%,bluish1green e)udatever' acute 3sread raidl' to all direction 3becauseroteol'tic en


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4arginal =lcer #tiology "taphylococcus affect limbal area

Fungal ulcer

history agriculture trauma topical steroid usage

gray nfiltrate thic% hypopyon irregular surface satellite lesions - in endothelium


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eres Simle) >eratitis.Etiolog' : 9S t'e I

corneal sensibilit' ???lesion : filament3 unctate3 dendritic3 disciform


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Moorens Ulcer

Etiology : antigen antibodies reaction

Progressive excavation of the limbus.


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TreatmenTreatmentt atroinee'e dros

Anti microorganismsdeend on laborator'finding (scraing & culture, Antibiotic for bacteria

Anti fungus for fungal infection

Antiviral for viral infection

igh dose 9it% A for >eratomalacia

Steroid for 4ooren-s ulcer

e'e bandage


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2rognosis deends on : deth & width of the ulcer

.orneal scar.orneal scar


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ebulaa%ula*eu%oma*eu%oma adherent

.entral 3118cornealblindness

2eriher' (*o visual

disturbance)


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2revention2revention

Avoid corneal trauma

Avoid overuse of toical steroid

.ure e)ternal e'e infection as soonas ossible%

Avoid trigger factor for relasing%simle) >eratitis%


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!ave a nice

day "


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Reference 0oo>s

0aughn 1, sbury 23 $eneral4phthalmology,56th edition, ppleton

*ange iller "3 +arson7s 1iseases of the eye,58

th #dition, Churcill *ivingstone, 59:;

ford ?utter @orth Aeineman*td, 5999

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