Introduction

• Cause: perforated corneal ulcer, trauma, foreign body.
• Signs: unilateral blepharospasm, ocular discharge, change in corneal appearance, conjunctivitis, epiphora.
• Diagnosis: history, clinical signs, ophthalmic examination.
• Treatment: broad spectrum antibiotics, topical serum, pain relief, third eyelid flap, corneal graft, enucleation.
• Prognosis: good if early treatment and no damage to deeper ocular structures.

Pathogenesis

Etiology

• Trauma.
• Perforated ulcer.
• Infection.
• Foreign body.

Predisposing factors

Specific

• Traumatic injury, eg grass seed perforation.
• Progression of corneal ulcer.

Pathophysiology

• If Descemet's membrane is breached, then loss of aqueous humor and iris prolapse occurs.
• The anterior chamber may collapse.
• Uveitis occurs.

Timecourse

• Usually seen as an acute problem.
• Healing tends to be slow.

Diagnosis

Treatment

Outcomes