Inflammation of the cornea

Clinical features

• Photophobia
• Severe ocular pain and associated foreign body sensation
• Hypopyon: aggregation of inflammatory cells within the anterior chamber resulting in visible 'sediment' in front of the eye inferiorly

Investigations

• Examination: anaethetics if photophobic, fluorescein, corneal reflex
• Corneal scrape: for gram stain and culture
  • In acanthamoeba ketatitis also culture contact lens

Bacterial keratitis

Causative organisms

• Involve Gram-positive and Gram-negative bacteria

Clinical features

• Usually associated with other corneal pathology or contact lens wear

Management

• Patient needs to be admitted for hourly antibiotic drops, patients require daily review
  • Ofloxin - treats most gram negatives
  • Gentamicin and cefuroxime - treats most gram positive and gram negative organisms

Herpetic keratitis (dendritic ulcer)

Causative organism

• Herpes simplex virus (HSV)