Keratitis, Infectious

Keratitis, Infectious


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Basic Information image



Definition




• Acute or chronic corneal ulcer with associated bacterial, fungal, or viral infection



Synonym(s)




• Infected corneal ulcers


• Fungal keratitis


• Bacterial keratitis



Epidemiology



Risk Factors




• Any type of ocular trauma


• Feeding hay from hay bags, nets, or balls



Geography and Seasonality




• Infectious keratitis is more common in warm, humid environments.



Clinical Presentation



Disease Forms/Subtypes




• Bacterial keratitis (Figure 1)


• Fungal (mycotic) keratitis (Figure 2)


• Viral keratitis


• Other infectious keratopathies (parasitic)


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FIGURE 1 Bacterial corneal ulcer in a horse. These are typically called melting corneal ulcers.


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FIGURE 2 Mycotic corneal ulcer in a horse. The white plaque is typical of fungal keratitis.



History, Chief Complaint




• Corneal ulceration with white to yellow cellular infiltrate, melting corneal ulceration, secondary uveitis



Physical Exam Findings




• A corneal ulcer is present when there is a break in the corneal epithelium. Clinically, this results in lacrimation, blepharospasm, photophobia, conjunctival hyperemia, corneal edema, and possibly miosis and aqueous flare. The diagnosis of a corneal ulcer is made based on these clinical signs and fluorescein staining of the cornea. Fluorescein stain will be retained by the underlying stroma and appear green in color.


• A corneal ulcer should be characterized regarding its size, depth, and the presence or absence of cellular infiltration. In addition, the anterior chamber is examined for anterior uveitis. It is essential with all corneal ulcers to attempt to establish the cause of the ulceration and eliminate it.


• The palpebral conjunctiva and bulbar surface of the nictitans are examined for the presence of a foreign body, the blink response and tear film are evaluated, and a complete history is obtained regarding trauma and previous medication. A history of previous topical corticosteroid therapy increases the likelihood of infectious, especially fungal, keratitis.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Keratitis, Infectious

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