ACANTHAMOEBA KERATITIS ® H/o contact lens wear ® Cleaning contact lens with water ® Pain out of proportion to signs d/t radial keratoneuritis
® Ring shaped ulcer ® Epithelial stippling
® Rx – DOC – PHMB (Poly Hexa Methylene Biguanide) o It is a swimming pool cleanser- Propamidine FUNGAL KERATITIS
® More damage less symptoms ® Cause –Fusarium (m/c), Aspergillus ® Predisposing factors - Injury with organic matter and prolonged use of topical steroids
® Finger like projections with feathery margins & satellite lesions ® Non sterile Hypopyon ® DOC- Natamycin VIRAL KERATITIS ® Dendritic ulcers caused by HSV ® Stained by fluorescence dye ® Only true dendrites are found ® loss of corneal sensation so these ulcers are painless ® Disciform keratitis (disc of edema) o Antigen antibody reaction o o d/t stromal involvement Rx – steroids (only keratitis where steroids can be used)
® Nummular keratitis o o Seen in HZO (Herpes Zoster Ophthalmicus) Hutchinson's Rule - if pt. develops vesicles on the tip of nose, the eye will definitely be involved as both are supplied by same branch of nasociliary nerve. ® Rx – Acyclovir (DOC) - Famciclovir
