Etiology

• Bacterial
  • Mostly GN: Pseudomonas aeruginosa
• Fungal
• Acanthamoeba
• Viral

Presentation

• severe pain, cannot open eye
• Conjunctival injection
• photophobia
• Corneal thinking
• White Corneal lesion
• Hypopyon

Risk Factor

• Contact lense wearer

Investigation

• Fluorescein + cobalt blue light → light up epithelial defect
  • Use TOP anesthetic Alcaine
    • don’t let patient take them home (risk of neurotropic ulcer, delay epithelial healing, tachyphylaxis
• Corneal scraping → send to culture and sensitivity
  • Scraping done with a blade, get sample around the margins
  • A swab from corner of the eye -> normal flora
  • Culture
    • Different for acanthamoeba (SDA agar)
  • Gram stain
    • +: Staphylococcus, streptococcus
    • : Pseudomonas

Types

Bacterial