- Inflammation of the conjunctiva and cornea induced by microbial
antigens.
- Causative organisms include: Staphylococcus aureus, Mycobacterium
tuberculosis, Chlamydia sp. Candida albicans and parasites (Ascaris
lumbricoides, Ancylostoma duodenale).
- Clinical features:
- Symptoms: foreign body sensation, photophobia, redness, irritation
and tearing.
- Signs:
- Single or multiple pinkish conjunctival or limbal nodules
0.5-3 mm in diameter
- Usually surrounded by conjunctival hyperemia
- Commonly develops ulcerative necrotic lesion over several
days
- May be triggered by active Staph. blepharitis
- May heal rapidly over 2 weeks without conjunctival scarring
- Corneal phlyctenulosis may cause ulceration and tend to
migrate centrally, may develop scarring and decreased vision
after healing
- Work up:
- Culture of the lids in patients with active blepharitis
- Conjunctival and corneal scraping may be indicated
- PPD with anergy panel (tuberculin skin) test
- Chest X-Ray if PPD is positive
- Management:
- Lid hygiene for Staph. blepharitis.
- Topical antibiotic with adjuvant topical steroids.
- Systemic antimicrobial therapy such as doxycycline for severe
blepharitis.
- Cycloplegic drop for patients with photophobia or severe corneal
involvement.
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