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?"
I promised a colleague i would post this one to get a group consensus Just to help my learning and this lady please….The therapeutics forum will let me watch but not add !!This young lady was a CL wearer presented to Musgrove A&E about a month ago initially treated but NO SCRAPE. I didn’t see … Continue reading "CLRK"
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"
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"
27 yo. Female. First seen 2011 associated with sihy oasys. Diffuse surface keratitis. Treated with no lenses, FML, lube. Refitted 6/52 later acuvue2. Now returned no lenses in for three months. Va 20/20. Tear lab 290. Mild papillae response greasy year film but normal lipiview. Any ideas ? hmm.. how to upload images
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
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"
Interesting take. Patient yesterday with RE quiet a/c, non ulcerative limbal infiltrate and sector redness, no discharge or photophobia, present 48 hours, no lenses and patient reports improving. Not great as she is extended wear but took lenses out at first indication and immediately felt better (no increase in pain on lens removal). I started … Continue reading "Overkill"
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"
Thoughts please… Doing glaucoma clinic in rural community hospital. 83yr old lady, poor VA LE from ARMD, now CF but previously 3/60. Px reports vaguley that VA LE seems worse over past 6 months. Hx of b/l trabs, b/l pseudophakia; Rx g. Xl on LE g. Az bd LE. Examination, LE lid oedema, LE diffuse … Continue reading "Stromal Necrotic HSK?"