Prof, DR, dr Rukiah Sawal SpM (K)

Anatomy and Physiology

Ant part of the eye

Avascular

ransparant

Refractin! and Protective

" window# of Route li!ht rays

(M$D%A R$&RA'A)
Fig .Anatomy
Fig. Histology
Transparancy

(nifor) Structure

Avascular

Detur!escence
Nutrition

Perili)*al capillaries

Air + tear fil)

A,ueous hu)or
%nnervation - . /0
Disease of the cornea
$1tre)ely serious
Per)anent visual i)pair)ent
2lindness
Pro)pt dia!nosis and pro)pt treat)ent
Pathology
'on!enital
%nfla)ation - Keratitis
u)or
rau)a
De!eneration
Keratitis

Keratitis - 3 Superficial
3 Profunda (interstitial)
3 .on ulceration
3 'ornea (lcer
Superficial - epithel and superficial stro)a
'ornea ulcer- defect 4 discontinuity
Superfcial Keratitis
&i! histolo!y
$tiolo!y -
3 %nfective
3 De!enerative
3 Aller!ic
3 o1ic
Classifcation
'ornea (lcer
05 2acterial
65 /iral
75 &un!al
85 9ypersensitivity reaction
:5 .eurothropic
;5 $1posure
<5 %diopathic
Clinical Presentation

Pain

Photopho*ia

=acri)ation

2lepharo spas)e

2lurred vision

Pericorneal 4 ciliary in>ection

%nfiltrate, ede), defect cornea

acterial Corneal !lcer
Si!ht ? threatenin!
3
Pro!ressive stro)al
3
Pro!resive tissue destruction
3
'orneal perforation
3
%nfection to ad>acent tissue
"is# Factors

'ontact lens wear

rau)a

'onta)inated ocular )edication

%)paired defense )echanis)

Altered structure of corneal surface

Clinical Persentation

Pain, photopho*ia, *lepharospas)e

lacri)ation, decreased vision

Pericorneal in>ection ? red eye

Sharply de)arcated epithelial defect

Stro)al ede)a
Suppurative Stro)al infla)ation

Ant cha)*er reaction - KP5 9ypopyon

Viral Corneal ulcer
'linical presentation
9SK

&orei!n*ody sensation, photopho*ia

=acri)ation, *lurred vision

Pericornea in>ection 4 ciliary flush

Rose *en!al, fluoroscein Stainin! (+)

Reduced corneal sensation

Keratitis herpes simple#s
H$%

@oster der)atitis affected . /0

Punctate or dendritic epithelial keratitis

:AB decreased corneal sensation

%ntestitial keratitis and anterior uveitis C

9SK
Fungal Corneal ulcer
Risk &actor -

Dardener - preplant or ve!eta*le

'ontact lens wear

'orticosteroid treat)ent topical 4 syste)ic

Clinical Presentation

Rese)*le with *atecterial ulcer

Dray3white infiltrate, irre!uler and fila)ent

)ar!ins

Satelite infiltrate

Anterior cha)*er reaction, hypopion

Hypersensiti&ity
reaction
05 Atopic keratocon>unctivitis
65 Steven Eohnson syndro)e
75 Fcular cicatrical Pe)phi!oid
85 Mooren (lcer
1
2
3
4
Treatment cornea ulcer

$tiolo!y 4 cause

Predisposin! factors

Potentially si!ht threatenin!

=ocal 3 cyclople!ic - atropin A5:B

3 Specific - anti*iotic, anti viral,
anti fun!al,
anti infla)ation 4
i))unosuppresive eye
drop 4 oint)ent

Syste)ik - oral - %/
Su*con>unctiva, su*tenon
3 Sur!ical ( co)plication )
Complications
05 'orneal scar - ne*ula, )acula, leuco)a
65 %ridocyclitis - Synechia, co)plited
cataract, secondary !lauco)a
75 Perforation
85 $ndofthal)itis
:5 Panophthal)itis
;5 Atrophia *ul*i
/isual i)pair)ent ? visual loss
Perforasi #ornea