Bilateral disciform keratitis as the presenting feature of extrapulmonary tuberculosis

At least seven to nine different species of fungi have been isolated in corneal ulcers and stromal abscesses in horses, but Aspergillus and Fusarium spp are the most frequent isolates. Corneal sensation was decreased in comparison to the right eye. They used a same confocal device with ours (HRT2-RCM), and obtained quite similar findings with our study: a distortion of the superficial and basal epithelium, the presence of irregular hyperreflective structures, and dendritic particles near the epithelial cells. (E … Bonferroni post hoc test was used for further analysis among the groups. It is estimated that as many as 75 percent of the reproductive-age population has been infected with one or more types of genital HPV and up to 5. To date, several in vivo confocal microscopic studies in both epithelial and nonepithelial type HSK have investigated subbasal nerve plexus abnormalities (density, branch, etc) and epithelial/stromal cell abnormalities (density, size, etc) with different types of confocal microscopes.4–8 For example, Rosenberg et al4 reported that dendritic structures, possibly Langerhans cells, were characteristically observed, at the level of the basal epithelium in resolved HSK cases, using a tandem scanning confocal microscope.

In all cases, the dendritic lesions consisted of hyperreflective irregular epithelial cells, and were surrounded by distorted and elongated epithelial cells. All experimental procedures were reviewed and approved by the University of Pittsburgh Institutional Animal Care and Use Committee (IACUC) (protocol number 13041595) and conformed to the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research (http://arvo.org/Journals_and_Publications/Animal_Research_Handbook/What_ARVO_Can_Do_For_You/). Infective, toxic, or immune corneal ulcers always present important ocular inflammation, stromal infiltrates, and symptoms. Effect of topical trifluridine on Thygeson’s superficial punctate keratitis. The half corneal tissue sent to microbiology for staining showed beaded organisms by Giemsa stain and the culture was negative for fungal growth. These two cases were observed for more than a decade with documented slow and insidious progression of the infiltrates despite the efforts in diagnosis and treatment. Traumatic causes may be avoided with the use of eye protection, for example.


The cause of stromal keratitis is thought to be retained viral antigen, which stimulates an immune reaction, rather than an infectious reaction. Brown SI, Grayson M. Corneal stromal scarring may indicate prior infection. He was fitted with a rigid gas permeable contact lens and achieved 20/25 vision in the left eye. Managing the complications of AKC and AKC therapy results in substantial problems for the patient and clinician. while 18 patients (15.8%) had recurrences only during summer months. Other complaints may include tearing, photophobia, and decreased vision.

Fine vascular loops are seen extending into the mid-stroma (black arrows). The changes result from hypertension-induced atherosclerosis blocking the small blood vessels of the retina. J Allergy Clin Immunol 2000; 106:1019–1032. “However, the patient adamantly denied this,” he says. Unilateral or bilateral. Subjects with acute BK at presentation were recruited from the Cornea & Refractive Surgery Service at the Massachusetts Eye and Ear Infirmary (Boston, MA, USA), between 2011 and 2013. The disease is often misdiagnosed and treated incorrectly.

Although less potent than IdUrd, AIU does provide effective therapy for herpes keratitis. These findings show bilateral immune alterations in a clinically unilateral disease. The important clue to diagnosis is the fact that the fundus will be hard to visualize and even if visualized details may be obscured. Corneal transparency is essential for vision, and thus the outer protective stratified corneal epithelium is under constant, rapid renewal with vigorous repair mechanisms. If you prefer to know exactly what goes into your natural moisturizer, you can make your own at home with propolis and essential oils. In addition to a strong correlation between corneal sensation and subbasal nerve plexus changes in HSK eyes, the authors were surprised to find a significant reduction in nerve plexus density in unaffected contralateral eyes as well as in affected eyes. The use of nerve growth factor in herpetic keratitis: a case report.

Recurrent blepharoconjunctivitis was noted in 8 eyes (57%), epithelial keratitis in 12 eyes (85.7%), stromal keratitis in 9 eyes (64.3%), necrotizing stromal keratitis in 5 eyes (35.7%), and progressive endotheliitis in 2 eyes (14.2%). The infection ultimately cleared in all eyes with topical therapy using chlorhexidine, propamidine, and antibiotic ointment with neomycin. Improvement of epithelial corneal defects, PUK, and visual acuity was achieved gradually during the follow-up period.CONCLUSIONS: Bilateral herpetic keratitis presenting as PUK is an extremely rare manifestation of herpetic disease. Eleven patients (48%) developed recurrent HSV keratitis at a median of 15 months after the first documented episode. The primary skin lesion of pemphigus vulgaris which was often fatal before the introduction of systemic glucocorticoid therapy, is a flaccid, fragile blister which can occur anywhere. After resolution of the infection, the patient was left with permanently reduced visual acuity. In vivo confocal microscopy and corneal sensation of the central cornea were performed bilaterally in all patients and in one random eye of controls.