Bacterial Corneal Ulcer/Hypopyon

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Bacterial Corneal Ulcer/Suppurative/Purulent Corneal Ulcer &

Hypopyon

Predisposing factors for bacterial corneal ulcer	Trauma,foreign body,entropion,trichiasis,contact lens use,chronic dacryocystitis,bullous keratopathy
Organisms invading injured cornea	Staphylococcus aureus, Streptococcus epidermis, Pneumococcus, Pseudomonas, Moraxella, Enterobacterias(E.coli,Proteus,Klebsiella)
Organism invading intact corneal epithelium	Neisseria gonorrhoeae, Neisseria meningitides, Corynebacterium, Listeria species, Haemophilus aegyptus
MC bacterial cause of keratitis	Staphylococcus aureus
MC bacterial cause of keratitis in a contact lense wearer	pseudomonas
MC viral cause of keratitis	HSV
The most important symptoms of bacterial corneal ulcer	Pain,lacrimation,foreign body sensation,conjunctival ingestion,photophobia,blurred vision
Earliest symptom	photophobia
Ulcer appearance in bacterial ulcer	Wet looking greyish white ulcer with distinct margins
Management of bacterial corneal ulcer	Topical antibiotics, atropine/cycloplegics(to relieve ciliary spasm,to prevent posterior synechiae), Anti glaucoma drugs
Hypopyon	Accumulation of polymorphonuclear leukocytes in the lower angle of anterior chamber
Most dangerous organisms producing hypopyon	Pseudomonas pyogenes, pneumococcus
Rapid corneal perforation	pseudomonas
Hypopyon corneal ulcer/ulcus serpens	pneumococcus
Corneal ulcer with hypopyon	Any other cause other than pneumococcus
Hypopyon in bacterial cause is	sterile(by toxin)
Hypopyon in fungal cause	Non sterile