Differentials
Corneal abrasion
SIGNS / SYMPTOMS
Epithelial defect without underlying stromal infiltrate.
Minimal inflammation and non-suppurative.
No or minimal anterior chamber inflammation.
Can become superinfected.
INVESTIGATIONS
Negative cultures of corneal scraping.
Vernal keratoconjunctivitis with shield ulcer
SIGNS / SYMPTOMS
Allergic papillary conjunctivitis with a shallow, shield-shaped sterile corneal ulcer, usually located superiorly.
Often bilateral.
Usually occurs in children.
Seasonal.
No anterior chamber inflammation.
INVESTIGATIONS
Negative cultures of corneal scraping.
Dry eye or exposure keratitis
SIGNS / SYMPTOMS
Multiple punctate epithelial erosions that may, in severe cases, coalesce into a larger epithelial defect.
Usually located inferiorly.
Non-suppurative.
No anterior chamber inflammation.
Can become superinfected.
INVESTIGATIONS
Negative cultures of corneal scraping.
Sterile corneal foreign body
SIGNS / SYMPTOMS
No or minimal immune corneal infiltrate.
No or minimal anterior chamber inflammation. Rust ring may be present in case of metal foreign body.
Symptoms and inflammation clear after removal of foreign body.
Can become superinfected.
INVESTIGATIONS
Negative cultures of corneal scraping.
Hypoxic or toxic corneal irritation
SIGNS / SYMPTOMS
Multiple, small, subepithelial infiltrates.
Usually bilateral.
Associated with poor contact lens fit, prolonged lens wear, or exposure to irritating solutions.
No or minimal anterior chamber inflammation.
INVESTIGATIONS
Negative cultures of corneal scraping.
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