Last reviewed: November 2017
Last updated: December  2017

Summary

Definition

History and exam

Key diagnostic factors

  • corneal infiltrate
  • corneal ulcer
  • periocular skin lesions
  • dendritic or geographic epithelial lesion
  • multifocal corneal ulcer with feathery edges
  • corneal perineuritis
  • interstitial keratitis

Other diagnostic factors

  • redness
  • pain
  • increased lacrimation
  • lid edema
  • discharge
  • decreased visual acuity
  • photophobia
  • high intraocular pressure
  • Hx of HSV or Varicella zoster virus infection
  • multiple old stromal scars
  • iris transillumination
  • corneal hypoesthesia

Risk factors

  • contact lens wear
  • corneal trauma
  • corneal abrasion/erosion
  • trichiasis
  • blepharitis
  • dry eye
  • poor eyelid function
  • previous herpetic disease
  • exposure keratitis
  • recurrent corneal erosions
  • contaminated water exposure
  • topical corticosteroid use
  • topical anesthetic use
  • previous eye surgery
  • immunocompromised
  • hx of autoimmune disease

Diagnostic investigations

1st investigations to order

  • corneal scraping: microscope slide
  • corneal scraping: cultures and sensitivity
Full details

Emerging tests

  • corneal scraping: PCR
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Director of Refractive Surgery

The Wilmer Eye Institute

The Johns Hopkins Hospital

Baltimore

MD

Disclosures

KSB declares that he has no competing interests.

Assistant Professor

Cornea, External Disease and Refractive Surgery

Kresge Eye Institute

Wayne State University

Detroit

MI

Disclosures

FSH declares that he has no competing interests.

Dr Kraig Scot Bower and Dr Frank S. Hwang would like to gratefully acknowledge Dr Julie Freidlin Leigh, a previous contributor to this monograph. JFL declares that she has no competing interests.

Peer reviewers VIEW ALL

Proctor Fellow in Cornea and External Disease

Francis I. Proctor Foundation

University of California

San Francisco

CA

Disclosures

MC declares that she has no competing interests.

Senior Lecturer & Consultant

Ophthalmic Surgeon

Division of Infection, Inflammation & Immunity

University of Southampton

Southampton General Hospital

Southampton

UK

Disclosures

PH declares that he has no competing interests.

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