BACTERIAL CORNEAL ULCER
BACTERIAL CORNEAL ULCER
- Also c/d suppurative keratitis .
- Due to organisms that produce toxin which cause tissue necrosis & pus formation in the corneal ulcer.
- Two main predisposing factors for bacterial corneal ulcer are:
- Damage to corneal epithelium
- Infection of the eroded area
- There are few species that are capable of penetrating an intact epithelium:
- Neisseria gonorrhoea
- Neisseria meningitis
- Corynebacterium diptheriae
- Listeria species
- Haemophillus agyptus
- Bacteria which cause corneal ulcer after epithelial injuries:
- Pseudomonas
- Pneumococcus
- Streptococcus epidermis
- Staphylococcus aureus
- Morexella
- Enterobacterias (E.coli, Proteus, Klebisella)
CLINICAL FEATURES
- Most important features are:
- Pain, lacrimation, foreign body sensation
- Conjunctival injection (red eye), photophobia & blurred vision.
- There is lid swelling, blepharospasm & yellow white areas of ulcer with swollen & overhanging margin may be seen.
Exam Important
- Most common bacterial cause of keratitis/corneal ulcer → Staphlococcus aureus
- Most common cause of keratitis/ corneal ulcer in a contact lens wearer → Pseudomonas
- Most common viral cause of keratitis/ corneal ulcer → HSV.
- Neisseria gonorrhoea invade the intact corneal epithelium and produce purulent corneal ulcer.
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