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Cornea & External Diseases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non Infectious
Circumcorneal thinning and mild neovascularization post rheumatoid-associated peripheral ulcerative keratitis.

  • Rheumatoid arthritis is the most common systemic, immune-mediated disease affecting the ocular surface.
  • Primarily affects middle age females.
  • Clinical features:
    • Episcleritis or scleritis
    • Mild superficial punctate keratitis or severe sclerosing keratitis
    • Peripheral corneal infiltrates which may progress to marginal furrowing, thinning or melting
    • Keratoconjunctivitis sicca (secondary Sjorgen syndrome)
  • Management:
    • Treatment is addressed primarily to the systemic condition.
    • Systemic and topical corticosteroids are useful for ocular inflammation.
    • Aggressive ocular surface lubrication and/or punctal plug for keratoconjunctivitis sicca.
    • Cyanoacrylate adhesive for severe corneal melting.
    • Lamellar or penetrating keratoplasty for perforation.

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