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Exposure Keratitis

Expsure Keratoconjunctiv


Presentation

  • Mean time from most recent FSS to presentation was 23 years (range, 17-36 years). On examination, 6 patients had related eyelid abnormalities, including bilateral entropion (1), ptosis recurrence (4), and peaked upper eyelid (1).[ncbi.nlm.nih.gov]
  • Alternatively, the eyepieces may be formed such that holes 18A and 18B are present in lenses 16A and 16B.[google.sr]
  • Summary We present four cases of corneal perforation in herpes zoster ophthalmicus. In all cases, corneal exposure, hypesthesia, and treatment with topical corticosteroids caused the perforation.[link.springer.com]
  • Presentation - patients who have undergone a keratoplasty and present with the symptoms outlined above should be assumed to have one of the above complications until assumed otherwise.[patient.info]
  • During his hospitalization, he presented a bilateral exposure keratitis complicated by an abscess and corneal perforation. The ocular surface is protected by the tear film, the blinking of eyelids and the lid closure.[panafrican-med-journal.com]
Disability
  • It is important to look out for the development of eyelid ectropion, which should be corrected when first diagnosed to prevent disabling, sight-threatening eye injury.[ncbi.nlm.nih.gov]
Varicella-Zoster Virus Infection
  • Rifkind D (1966) The activation of varicella zoster virus infections by immunosuppressive therapy. J Lab Clin Med 68: 463 PubMed Google Scholar 28.[link.springer.com]
Vomiting
  • In the immediate postoperative period, she experienced quite severe general anesthetic induced nausea and vomiting and a delay in waking up completely. DDX and mx? 29 thanks, comments 19 Sep 2016 Thank Post[dailyrounds.org]
Heart Failure
  • It’s contra-indicated in case of kidney failure, recent heart attack, heart failure, angina, stroke and high blood pressure – The ptosis is different from a droopy eyebrow, which can occur after injection into the forehead for cosmetic injection or facial[infodystonia.com]
Flushing
  • Each valve assembly is preferably attached to a respective lens such that the inserted end of the valve assembly is substantially flush with the inner surface of the lens.[google.sr]
Foreign Body Sensation
  • 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[dro.hs.columbia.edu]
  • Symptoms: Because patients with loss of trigeminal function are free of pain, they will experience only slight symptoms such as a foreign body sensation or an eyelid swelling.[alpfmedical.info]
  • .  Foreign body sensations.  Photophobia.  Tearing.  Punctate epithelial erosions;  usually inferior if underlying lagophthalmos.  central if due to proptosis.  Larger defects- opportunistic microbial keratitis;- perforation.  Corneal anaesthesia[slideshare.net]
  • Meibomian Gland Dysfunction Symptoms : Irritation, redness, burning, foreign body sensation, blurred vision throughout the day. Clinical Signs : Capped or dysfunctional meibomian glands.[newgradoptometry.com]
  • Diagnosis Symptoms: Ocular irritation, burning, itching, pain, foreign-body sensation, photophobia, and blurred vision Examination: Conjunctival injection/inflammation, decreased tear meniscus, decreased tear break-up time, increased debris in the tear[biotissue.com]
Red Eye
  • CLINICAL FEATURES  Irritable, red eye(s); may be worse in the mornings.  Foreign body sensations.  Photophobia.  Tearing.  Punctate epithelial erosions;  usually inferior if underlying lagophthalmos.  central if due to proptosis.  Larger defects[slideshare.net]
  • Contact lens acute red eye (CLARE) — a non-ulcerative sterile keratitis associated with colonization of Gram-negative bacteria on contact lenses.[ipfs.io]
  • Contact lens acute red eye (CLARE) — a non-ulcerative sterile keratitis associated with colonization of Gram-negative bacteria on contact lenses. Treatment [ edit ] Treatment depends on the cause of the keratitis.[en.wikipedia.org]
  • Phlyctenulosis - small pinkish-white nodule with an associated red eye. It occurs as a result of a nonspecific delayed hypersensitivity reaction to bacterial and viral antigens.[patient.info]
Excessive Tearing
  • She is c/o excessive tearing from her left eye, photophobia, a moderately severe burning sensation and discomfort and blurred vision.[dailyrounds.org]
  • My patients report that the shield shelters eyes from excess tear evaporation, while also fogging up, creating a moisture rich environment for the eyes.[newgradoptometry.com]
  • The back-surface toricity improves alignment of the lens to the sclera and reduces the excessive tear exchange that carries the debris (Figure 5). Figure 5.[clspectrum.com]
Corneal Opacity
  • A 4-Month-Old Female Infant with Hydrocephalus and a History of Prematurity (30 Weeks’ Gestation, 900 Gram Birth Weight) Was Evaluated Because of Left Corneal Opacity.[healio.com]
  • The most common causes of loss of corneal transparency are: Corneal Oedema Drying of Cornea Depositions on Cornea Inflammations of Cornea Corneal Degenerations Dystrophies of cornea Vascularization of cornea Scarring of Cornea Corneal Opacities [ edit[en.wikibooks.org]
  • It is one of the corneal ectasias (see 'Corneal ectasias', below) and may be associated with Ehlers-Danlos syndrome type IV. [ 10 ] Corneal opacities The cornea may be cloudy at birth for a number of reasons: these babies should be referred for urgent[patient.info]
Unilateral Ptosis
  • Four patients had bilateral, congenital ptosis and 3 had unilateral ptosis, secondary to childhood trauma (2) and third nerve palsy (1). Mean age at first FSS was 6 years (range, 9 months-14 years).[ncbi.nlm.nih.gov]
Fear
  • The ophthalmologist whom he attended regularly was unwilling to perform ptosis operation for fear of exposure keratitis as his Bell's phenomenon was poor. On examination, the vision in each eye was normal at 6/6 with glasses.[sarawakeyecare.com]
Facial Burn
  • Chronic exposure of the cornea can occur following facial burns that cause eyelid ectropion. This complication can be difficult to diagnose in the unconscious patient.[ncbi.nlm.nih.gov]
Meningism
  • Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine Subject Essential blepharospasm, exposure keratitis, lag ophthalmus, punctate keratitis, contact lens, blepharoplasty, bullous keratopathy, Shirmer's test, factitious meningitis[collections.lib.utah.edu]

Workup

  • Workup : Case history. Evaluate eyelid closure and corneal exposure. Check corneal sensation. Look at tear film and corneal integrity with flourescein dye.[newgradoptometry.com]

Treatment

  • This study reports the surgical technique of modified medial tarsorrhaphy using tarsoconjunctival advancement flap for treatment of exposure keratitis secondary to incomplete lid closure combined with ocular dysmotility or decreased corneal sensation.[ncbi.nlm.nih.gov]
  • Treatment: This is essentially identical to treatment of exposure keratitis. It includes moistening the cornea, antibiotic protection as prophylaxis against infection, and, if conservative methods are unsuccessful, tarsorrhaphy.[alpfmedical.info]
  • Treatment of cause of exposure: If possible cause of exposure (proptosis, ectropion, etc) should be treated. 2. Treatment of corneal ulcer is on the general lines 3.[ophthalmologylife.blogspot.com]
  • In all cases, corneal exposure, hypesthesia, and treatment with topical corticosteroids caused the perforation. Corneal perforation can occur without zoster keratouveitis.[link.springer.com]
  • What's the Treatment? Your doctor may suggest: Drops or ointments. These keep your eyes moist, which eases the problem. You might need to use artificial (fake) tears several times a day. The doctor might give you an ointment or gel to use at night.[webmd.com]

Prognosis

  • In a 36 years old patient the prognosis of a peripheral facial nerve palsy and trigeminal palsy after surgery of an acoustic neuroma was judged to be good.[dog.org]
  • […] trial, or Login Diagnosis This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Treatment This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Prognosis[vetstream.com]
  • As always, rapid treatment improves the prognosis.[imo.es]
  • Prognosis Mild EK has an excellent prognosis, with most if not all patients making a full recovery if the cornea remains intact without erosion, ulceration, or microbial infection. [18] Severe cases can lead to scarring, perforation and permanent vision[eyewiki.aao.org]
  • Prognosis Some infections may scar the cornea to limit vision. Others may result in perforation of the cornea, (an infection inside the eye), or even loss of the eye.[ipfs.io]

Etiology

  • Etiology: The trigeminal nerve is responsible for the cornea's sensitivity to exogenous influences.[alpfmedical.info]
  • Get a balanced view of etiology, diagnosis, and management, and access unique guidance on the practical problems encountered in real-life clinical cases. Impresses the importance of systemic disease in diagnosis and management.[books.google.com]
  • Image Source: Review of Optometry Potential Etiologies : Some studies suggest an abnormality in collagen or elastin fibers.[newgradoptometry.com]
  • If the eyelids are everted easily, especially in patients with a history of sleep apnea or snoring, floppy eyelid syndrome may be the underlying etiology. Proptosis.[aao.org]
  • Non-Ulcerative Keratitis Superficial keratitis Diffuse superficial keratitis Superficial Punctate Keratitis (SPK) Deep Keratitis Non-suppurative Interstitial Disciform Sclerosing Keratitis Profunda Suppurative Central Corneal Posterior Corneal Etiological[en.wikibooks.org]

Epidemiology

  • Epidemiology: Palsy of the ophthalmic division of the trigeminal nerve is less frequent that facial nerve palsy. Etiology: The trigeminal nerve is responsible for the cornea's sensitivity to exogenous influences.[alpfmedical.info]
  • Sokal JE, Firat D (1965) Varicella zoster infection in Hodgkin’s disease: Clinical and epidemiological aspects. Am J Med 39: 452 Google Scholar 29. Elliott FA (1964) Treatment of herpes zoster with high doses of prednisone.[link.springer.com]
  • Since data on the epidemiology of NK are not available from the literature, the prevalence and incidence of NK may be estimated as being below 1.6/10,000 from the epidemiological data on conditions associated with NK, such as herpetic keratitis (1.22[dovepress.com]
  • A.Congenital upper eyelid coloboma: embryologic, nomenclatorial, nosologic, etiologic, pathogenetic, epidemiologic, clinical, and management perspectives.[eyewiki.aao.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of this keratitis involves subtle and undetected incomplete eyelid closure which chronically exposes the inferior one-third of the cornea.[ncbi.nlm.nih.gov]
  • Neurotrophic keratopathy; its pathophysiology and treatment. Histol Histopathol . 2010 Jun. 25(6):771-80. [Medline] . Hauck MJ, Harold Lee H, Timoney PJ, Shoshani Y, Nunery WR.[emedicine.staging.medscape.com]
  • Etiology, Pathophysiology Figure 1: Tear film diagram.[eyewiki.aao.org]

Prevention

  • Prevention by frequent application of ocular lubricants and taping of the eyelids is recommended.[ncbi.nlm.nih.gov]
  • Thus, none of these conventional methods effectively prevent a patient from developing cornea damage.[google.sr]
  • Once lagophthalmos is diagnosed following measures should be taken to prevent exposure keratitis. Frequent instillation of artificial tear eyedrops. Instillation of ointment and closure of lids by a tape or bandage during sleep.[ophthalmologylife.blogspot.com]

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