H. IZAR AZIZ
Dr.H.Izar Aziz,SpM(K)
by :
Dr.H.Izar Aziz,SpM(K)
Keratitis : is
Dr.H.Izar Aziz,SpM(K)
Epithelium covered by tear film :as a barrier microorganisms infection . (except N. Gonorrhoea) Descemets membrane as barrier for bacterial infection to COA .(but not for fungus)
Etiology of keratitis :
Exogenous : bacteria ,fungus , virus, parasite Endogenous : allergic reaction.
Dr.H.Izar Aziz,SpM(K) 5
Bacteria :
-Pure Pathogen : Streptococcus pneumoniae, Pseudomonas aeroginosa
Pathogen bacteria
Dr.H.Izar Aziz,SpM(K)
Corneal infection
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opportunistic)
Dr.H.Izar Aziz,SpM(K)
Objective -
blepharospasme ciliary injection tearing (lacrimation) superficial infiltrate or corneal ulcer hypopyon- in advanced cases.
Dr.H.Izar Aziz,SpM(K)
Dr.H.Izar Aziz,SpM(K)
Special examinations :
Flourescein test for corneal ulcer Seidel test for perforating cornea
Dr.H.Izar Aziz,SpM(K)
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Laboratory Studies
Etiologic diagnosis. Scraping from: infiltrate / edge of the ulcer fornices of conyunctiva Slide Staining : Gram ( for bacteria) Giemsa (for fungus )
Dr.H.Izar Aziz,SpM(K)
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Clinical course
Subepithelial /epithelial keratitis
Recover without scar
Recover with scar
Nebula Makula Leukoma
Advanced inflamation
-endophtalmitis -panophtalmitis recover
Extirpation of the globe
Corneal blindness
Permanent blindness
Abulbi 12
Dr.H.Izar Aziz,SpM(K)
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Pseudomonas ulcer.
Etiology : Pseudomonas aerg. (present in Flourescein sol.) bluish-green exudate very acute ,spread rapidly to all direction ,because proteolytic enzyme destroy the corneal stroma
descemetocele
Dr.H.Izar Aziz,SpM(K)
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Etiology : Staphylococcus affect limbal area history: agriculture trauma topical steroid usage >>>>
gray Infiltrate thick hypopyon & irregular surface satellite lesions - in endothelium
Dr.H.Izar Aziz,SpM(K)
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Etiology : VHS type I corneal sensibility <<< lesion : filament, punctate, dendritic, disciform
Dr.H.Izar Aziz,SpM(K)
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Moorens Ulcer
Etiology : antigen antibodies reaction Progressive excavation of the limbus.
Dr.H.Izar Aziz,SpM(K)
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Keratomalacia Etiology : Vitamin A deficiency advance stage of xerosis conjunctiva & cornea No ciliary injection
Dr.H.Izar Aziz,SpM(K)
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Treatment
atropine eye drops Anti microorganisms depend on laboratory finding (scraping & culture)
Antibiotic for bacteria Anti fungus for fungal infection Antiviral for viral infection
eye bandage
Dr.H.Izar Aziz,SpM(K)
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Prognosis depends on :
Corneal scar
Dr.H.Izar Aziz,SpM(K)
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Dr.H.Izar Aziz,SpM(K)
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Prevention
Avoid corneal trauma Avoid overuse of topical steroid Cure external eye infection as soon as possible. Avoid trigger factor for relapsing H.simplex keratitis.
Dr.H.Izar Aziz,SpM(K)
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Dr.H.Izar Aziz,SpM(K)
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Reference Books
Vaughn D, Asbury T; General Ophthalmology, 15th edition, Appleton & Lange Miller S; Parsons Diseases of the eye, 17 th Edition, Churcill Livingstone, 1984 Kanski JJ, Clinical Ophthalmology, 4th edition,Oxford Butter Worth Heineman Ltd, 1999
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