Corneal Abrasions vs Ulcers Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a characteristic difference between corneal abrasions and corneal ulcers?

Corneal abrasions result in corneal clarity, while ulcers do not. (correct)

Abrasions are always accompanied by inflammation.

Corneal ulcers are usually treated by general practitioners.

Ulcers heal within 24-48 hours, while abrasions do not.

Which of the following symptoms is commonly associated with both corneal abrasions and ulcers?

Excessive tearing

Bacterial infection

Painful, red eyes (correct)

Clear vision

In what situation would a patient likely require immediate referral to an ophthalmologist?

Having a history of eye infections and displaying clear symptoms.

Experiencing persistent symptoms after injury. (correct)

Sustaining an eye injury with no visible damage.

Developing a corneal abrasion after sports.

Which group of patients is at a higher risk for developing corneal ulcers?

Contact lens wearers. Signup and view all the answers

What typically causes corneal abrasions to occur during lens handling?

Inserting and removing contact lenses. Signup and view all the answers

What is the typical healing time for corneal abrasions?

24-48 hours Signup and view all the answers

What initial assessment is crucial in determining the treatment for an eye injury?

Understanding the mechanism of trauma. Signup and view all the answers

What is one common misconception about corneal ulcers?

They are often healed by general practitioners. Signup and view all the answers

What is the commonest cause of recurrent corneal ulceration?

Herpes simplex Signup and view all the answers

What does dramatic relief of symptoms after instilling a topical anaesthetic indicate?

Surface problem of the eye Signup and view all the answers

How does vision typically differ between a corneal abrasion and a corneal ulcer?

Abrasions usually have near normal vision Signup and view all the answers

What characteristic of the eye is observed in patients with corneal ulcers?

Deeply injected and mucopurulent discharge Signup and view all the answers

Which of the following is essential for examining a patient with suspected corneal lesions?

Comparison of corneas for clarity Signup and view all the answers

What can fluorescein staining confirm in a patient being examined for corneal issues?

Epithelial defect Signup and view all the answers

What is a typical symptom of an eye with an abrasion?

Mild hyperemia and watery eye Signup and view all the answers

When assessing a patient's pupil in cases of corneal injury, which of the following is typically observed?

Round but small pupil Signup and view all the answers

Which treatment is appropriate for recurrent infections if the patient's vision is good?

3% Zovirax ointment five times daily Signup and view all the answers

What should NOT be done in cases of infectious keratitis?

Instill antibiotic agents Signup and view all the answers

When should patients with minor abrasions return for a follow-up?

Only if symptoms worsen or fail to resolve Signup and view all the answers

Corneal abrasions are best described as:

Areas of epithelial loss without corneal opacity Signup and view all the answers

Patients with large corneal abrasions should be reviewed within what timeframe?

The following day Signup and view all the answers

What is the classical appearance of marginal ulcers?

Banana-shaped lesions separated from the limbus Signup and view all the answers

Which condition is most commonly associated with the development of infectious keratitis in healthy adults?

Corneal injuries from vegetable matter Signup and view all the answers

What is a key indicator of herpetic keratitis?

Presence of a dendritic ulcer Signup and view all the answers

What denotes a sinister sign in the context of keratitis?

Presence of a hypopyon Signup and view all the answers

How do marginal ulcers typically manifest in terms of epithelial loss?

No epithelial loss is usually seen initially Signup and view all the answers

What increases the risk of developing ulcers in contact lens wearers?

Improper hygiene and care of lenses Signup and view all the answers

What type of inflammation may develop in patients suffering from herpetic keratitis?

Disciform stroma keratitis Signup and view all the answers

Which of the following statements about marginal ulcers is incorrect?

They are usually found centrally in the cornea. Signup and view all the answers

What does corneal clouding generally indicate?

Stromal swelling or infiltration Signup and view all the answers

Which condition is characterized by severe pain upon awakening?

Recurrent erosion syndrome Signup and view all the answers

What typically causes marginal ulcers?

Staphylococcal blepharitis Signup and view all the answers

What is the expected healing time for corneal epithelial defects in recurrent erosion syndrome?

12 to 24 hours Signup and view all the answers

How is a corneal abrasion identified during an examination?

Fluorescein staining that highlights the defect Signup and view all the answers

What is the primary reason for experiencing pain in recurrent erosion syndrome?

Tearing of the corneal epithelium Signup and view all the answers

What symptom is commonly associated with a hypopyon?

Cloudy cornea Signup and view all the answers

What is a common indication that may prolong the healing time of a corneal abrasion?

Epithelial barrier disruption Signup and view all the answers

Which condition is characterized by a corneal defect?

Dendritic ulcer Signup and view all the answers

What is the suggested treatment for a simple abrasion caused by a clean object with minimal pain?

Ophthalmic ointment instillation Signup and view all the answers

What should never be prescribed for treating abrasions?

Topical anaesthetic agent Signup and view all the answers

Which of the following treatments can help relieve pain in patients with severe abrasions?

Short acting cycloplegic agent Signup and view all the answers

What is the role of paraffin ointment in the treatment of recurrent erosion syndrome?

Acts as a preventative strategy Signup and view all the answers

What combination is commonly used to treat marginal ulcers?

Steroids and antibiotics combined Signup and view all the answers

How often should treatment for recurrent marginal ulcers be applied during the initial 10-day treatment period?

Four times a day Signup and view all the answers

What management is recommended for contact lens wearers experiencing an abrasion?

Remove lenses until the eye feels normal Signup and view all the answers

Study Notes

Corneal Abrasions and Ulcers

Corneal abrasions are areas of the cornea without surface epithelium, typically caused by minor trauma.
They are usually clear and heal within 24-48 hours.
Corneal ulcers are areas of corneal epithelium loss with inflammation and/or infection.
Corneal ulcers are potentially sight-threatening.
Immediate ophthalmologist referral is needed for ulcers.

History

Patients with abrasions or ulcers often report pain, redness, sensitivity to light, and a foreign body sensation.
History of trauma is important for both abrasions and ulcers.
Determine duration of the problem as persistent or worsening symptoms suggest an ulcer.
Ask about risk factors for ulceration and infection, such as immunocompromise, dry eyes, blepharitis, and contact lens wear.
Previous corneal ulcers, particularly herpetic keratitis, need to be investigated.

Examination

Examination is crucial to differentiate between abrasions and ulcers.
Use a bright light and magnification if possible for detailed corneal assessment.
Staining with fluorescein helps identify epithelial defects.
Assess corneal clarity, noting any cloudiness which suggests stromal inflammation or infection.
Check for hypopyon (pus in the anterior chamber).
Consider topical anesthetic if examination is difficult.
Important to check vision and pinhole vision

Common Ulcer Syndromes

Recurrent Corneal Erosion Syndrome:
- Characterized by recurrent episodes of pain and vision loss typically in the morning.
- Usually associated with a brief history of ocular trauma.
Marginal Ulcers:
- Common, frequently recurring, often related to staphylococcal blepharitis with immune reaction.
- Classic appearance at the limbus (junction of cornea and sclera).
Herpetic Keratitis:
- Common recurrent infection characterized by a dendritic ulcer in some cases.
- Can lead to more severe corneal involvement, disciform stromal keratitis, resulting in impaired vision.
Infectious Keratitis:
- Infectious origin, necessitates urgent ophthalmologist referral.
- Associated with corneal opacity, hypopyon

Differential Diagnosis

Other potential diagnoses include foreign body, conjunctivitis, and iritis, all of which should be ruled out.

Treatment

Simple abrasions:
- Treatment depends on pain levels, infection risks, and presence of trauma or other factors.
- Use antibiotic ointment or padding for severe pain.
- Avoid topical anesthetic.
Recurrent erosion syndrome:
- Immediate treatment as per abrasion.
- Long-term prevention and reassurance.
- Use soft ointments like paraffin (Lacrilube) at night.
Marginal ulcers:
- Typically treated with combined steroid and antibiotic agents such as Maxitrol.
Dendritic ulcers:
- Semi-urgent ophthalmologist referral for recurrent or significant cases.
Infectious keratitis:
- Immediate ophthalmologist referral.
- Avoid antibiotic or anesthetic instillations to preserve microbiological specimens.

Follow-up

Minor abrasions may not require follow-up, but review for worsening symptoms or signs of complication.
Major abrasions or patients with significant symptoms need re-evaluation within 24 hours.
Regularly evaluate for improvement/worsening symptoms

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the differences and similarities between corneal abrasions and ulcers. This quiz covers symptoms, treatment, and assessment necessary for eye injuries. Perfect for students and professionals in the field of ophthalmology.