New Zealand shaped keratitis – what whould you do?

50 year old healthy female, part-time contact lens wearer (dailies) Ended up referring this one as not got much experience with HZO Referral letter via NHS mail: ____________________________________________________________________ Please could you ask Dr Xxxx if he wouldn’t mind seeing this lady in his Xxxx clinic over the next month or so. Alternatively, if he could … Continue reading "New Zealand shaped keratitis – what whould you do?"

Long term toxicity to prophylactic oral aciclovir

Looking for some advice. Have a patient who has a history of recurrent HSV keratitis. Now has VA 6/12+2 in affected eye due to corneal scarring. Last attack was 2 years & 3 months ago. She  been taking 2x400mg oral aciclovir + one drop per week of maxidex. She has been for her annual check … Continue reading "Long term toxicity to prophylactic oral aciclovir"

VKC in a 5yr old

On Friday I saw a very sweet little 5 year old boy with irritable pink eyes, slightly photosensitive (not photphobic) which was not responsive to 3 weeks of topical antibiotics.  Fairly atopic with asthma, eczema and hayfever. VA was 6/9.5 in both eyes.  mild conj hyperaemia, mild inferior SPK on the left cornea, huge cobblestone … Continue reading "VKC in a 5yr old"

HSK –

HI all   I managed to take a pic of HSK – When do folks add steroids? I’ve added at follow up providing the defect is healing but I know of consultants that provide predforte and acyclovir at the same time… Do you think this lesion requires the addition of steroid? https://www.dropbox.com/s/uclbx8rpn3c426h/Photo%2013-09-2014%2010%2043%2006.png?dl=0 Irfan

unusual no staining diffuse keratitis in 8 yo boy

child hit in R eyebrow playing water polo. Not KO but a thump by all  accounts. 24 hours later c/o blurred vision LE. Child well known to us and usually 6/5, 6/5 plano & straight. RE clear. LE 6/9 diffuse non staining keratitis ? corneal opacity sub epithelial upper temp quadrant encroaching pupil, not spot … Continue reading "unusual no staining diffuse keratitis in 8 yo boy"

Dealing with Non-Attenders

A 22 y/o white male soft contact-lens wearer presented on 8th November with a 7-10/7 history of a sore,red, watery RE.  Px admitted to having slept overnight in his contact lenses 7-10/7 prior to this visit (he actually has documented history of non-compliant behaviour).  He’d consulted an out-of-hours GP service 3 days before seeing me … Continue reading "Dealing with Non-Attenders"