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Cornea & External Diseases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non Infectious
Exposure Keratitis

  • May result from any disease process that causes inadequate eyelid closure.
  • Causes include:
    • Neurogenic diseases such as Bell's palsy, acoustic neuroma.
    • Proptosis due to thyroid orbitopathy or other orbital diseases.
    • Eyelid dysfunction from restrictive eyelid diseases or previous blepharoplasty.
    • Inattentive mental states such as in comatose patients or nocturnal exposure
  • Clinical features:
    • Symptoms:
      • Foreign body sensation, itching, burning and conjunctival injection
      • Decreased vision
      • Pain and photophobia may occur
    • Signs:
      • Superficial punctate epithelial staining involves inferior third of the cornea
      • May progress to large area of epithelial defect and complicated with corneal infiltrates, ulceration, perforation or endophthalmitis
  • Management:
    • Most important is treatment of underlying cause(s).
    • Nonpreserved topical drops during the day and lubricating ointment at bedtime.
    • Antibiotic for epithelial corneal defects.
    • Lid taping.
    • Moisture chamber glasses.
    • Temporary tarsorraphy.
    • Definitive surgical therapy.

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