Clinical Work-Up of Corneal Ulcers

Abstract

Microbial keratitis is a significant cause of corneal blindness and ocular morbidity in the developing world. The problem is compounded by easy access to over-the-counter medications, delay in presentation to eye care facility, and irrational management. It is crucial to systematically work up a case of microbial keratitis so as to assess the severity of the disease, identify a probable etiologic agent, and direct treatment in order to avoid or minimize complications. It is important to document all cases of microbial keratitis with a clinical picture or diagrammatic representation. Predisposing factors for microbial keratitis include history of trauma, contact lens wear, abnormal ocular surface, or prior corneal surgery. Various microorganisms have typical presentation and clinical manifestations. Eliciting the appropriate history and clinical signs assists the examiner in directing appropriate diagnostics and therapy. Clinical examination alone may not be relevant and needs microbiologic or pathologic evaluation for definitive diagnosis and treatment.