Neurotrophic Keratopathy

Neurotrophic Keratopathy SYMPTOMS Possible irritation | Blurry vision | Usually asymptomatic SIGNS Epithelial punctate defects | Injection | Corneal ulcer with rolled edges | Corneal thinning WORK-UP Thorough history and slit lamp examination with NaFl stain | Test corneal sensitivity (i.e. cotton wisp test) TREATMENT Preservative-free artificial tears 1 gtt q1-3h | Topical vigamox or…

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Thygeson Superficial Punctate Keratitis

Thygeson Superficial Punctate Keratitis SYMPTOMS Tearing | Pain | Photophobia | Foreign body sensation SIGNS Multiple round, white-gray intraepithelial opacities WORK-UP Thorough history. Slit lamp examination TREATMENT Preservative-free artificial tears | Topical steroids (Pred Forte 1% or Lotemax 1 gtt qid) FOLLOW-UP Weekly ADDITIONAL LAB | TESTS None ETIOLOGY Unknown. Both viral and immune-mediated mechanisms…

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Interstitial Keratitis (IK)

Interstitial Keratitis (IK) SYMPTOMS Pain | Photophobia | Blurry vision SIGNS Stromal edema, opacification, and neovascularization | Anterior chamber cells/flare WORK-UP Thorough history, slit lamp examination, dilated fundus exam TREATMENT Treat underlying disease | A corneal transplant may be indicated in cases of severe corneal scarring and poor vision. Topical steroids: Pred Forte 1% 1…

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Acanthamoeba Keratitis

Acanthamoeba Keratitis SYMPTOMS Pain (usually severe) | Photophobia | Blurry vision SIGNS Injection | Epitheliopathy | Corneal haze | Ring-shaped infiltrate | Anterior chamber cells/flare | Hypopyon WORK-UP Thorough history and slit lamp examination | Culture and possible corneal biopsy | Confocal biomicroscopy may be used TREATMENT Discontinue contact lens wear (if applicable) | A…

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Herpes Zoster Ophthalmicus (HZO)

Herpes Zoster Ophthalmicus (HZO) SYMPTOMS Photophobia | Blurry vision | Pain | Malaise SIGNS Stromal edema | Neovascularization | Stromal infiltrates | Pseudodendrite | Possible high IOP | Vesicular skin rash respecting the midline | Possible Hutchinson sign WORK-UP Thorough history. Slit lamp examination TREATMENT Oral antivirals: Acyclovir 800 mg 5x/day x 7-10 days |…

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Herpes Simplex Keratitis

Herpes Simplex Keratitis SYMPTOMS Pain | Photophobia | Tearing | Blurry vision SIGNS Injection | Tearing | Vesicles/dendrites | Possible geographic ulcer WORK-UP Thorough history. Slit lamp examination TREATMENT Topical antivirals: Zirgan 1 gtt 5x/day | Trifluridine 1% 9x/day Oral antivirals: Acyclovir 400 mg 5x/day x 7-10 days | Valacyclovir 500 mg tid x 7-10…

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Dry Eye Syndrome (DES)

Dry Eye Syndrome (DES) SYMPTOMS Dryness | Tearing | Discomfort | Transient blur | Photophobia SIGNS Injection | Tearing | Discharge | Cornea/conjunctiva stain with NaFl/LG | Low tear meniscus WORK-UP Thorough history. Slit lamp examination TREATMENT Treatment depends on the severity of the condition (non-exhaustive list) Mild DES: Preservative-free artificial tears 1 gtt bid-qid…

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