Bacterial Corneal Ulcer

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:

  1. Damage to corneal epithelium
  2. Infection of the eroded area

There are few species that are capable of penetrating an intact epithelium:

  1. Neisseria gonorrhoea
  2. Neisseria meningitis
  3. Corynebacterium diptheriae
  4. Listeria species
  5. Haemophillus agyptus

Bacteria which cause corneal ulcer after epithelial injuries:

  1. Pseudomonas
  2. Pneumococcus 
  3. Streptococcus epidermis
  4. Staphylococcus aureus 
  5. Morexella
  6. Enterobacterias (E.coli, Proteus, Klebisella)

CLINICAL FEATURES

Most important features are:

  1. Pain, lacrimation, foreign body sensation
  2. 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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