Cornea - I Free Papers - aioseducation

Cornea Free Papers
A common protocol was applied to all cases. Each patient was examined
under Slit Lamp biomicrocope by an ophthalmologist. Ulcer is stained by
Sterile fluorescein strip touched at the lower fornix to make out the extent of
epithelial breech and recorded in mm in its longest and shortest diameter.
Other details like depth, zone of stromal infiltrate, Corneal edema etc are
noted with proper color coding. Hypopyon is measured in mm and number of
days for its resolution is noted.
Healed Ulcer
An ulcer is defined healed where fluorescein staining is negative and there is
no stromal infiltrate.
Meticulous data was collected on the following:
1. Date of first visit.
2. Date at which ulcer has healed .
3. Size of ulcer at first visit
4. Site of ulcer (central , inferior temporal , inferior nasal , superior temporal,
inferior temporal)
5. Hypopyon present on presentation and its resolution time.
6. Best corrected visual acuity at first visit.
7. Best corrected visual acuity at end of treatment.
Exclusion criteria
Associated systemic ailments like Diabetes etc.
Associated ocular conditions like dry eye, dacryocystitis, blepharitis, lid
pathologies etc. Typical viral ulcers, healing ulcers, moorens , interstitial
keratitis, neurotropic ulcer, bullous keratopathy, exposure keratopathy etc.
Scraping
The cornea and conjunctival sac are anesthetized with proparacaine
hydrochloride (0.5%), Epithelium is scraped from over the ulcer and beyond.
Ulcer is scraped by an ophthalmologist under aseptic conditions ,at the slit
lamp, using sterile Bard Parker Blade no 15.
Material is obtained from
1. The bed of the ulcer
2. Leading edge of the ulcer and a KOH mount prepared for examination
under microscope first under 10 x and then finally under 40x.
Detailed microbiological examinations like fungal and bacterial culture etc
are done as part of hospital protocol but has not been taken into consideration
in this study as these are not feasible at the grass roots level. It is obviously
ideal to inoculate into several media but this is not always possible due to
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