Marginal Keratitis ● Hypersensitivity reaction due to Staphylococcus Aureus exotoxins in the peripheral cornea ● Patients have associated Staphylococcal blepharitis/ conjunctivitis Mechanism: ● Type III Hypersensitivity ● Antigen-antibody complexes deposited in peripheral cornea → complement pathway activated and neutrophil attraction → peripheral stromal infiltrates → epithelial breakdown and ulceration
Signs : ● Subepithelial- Stromal infiltrates at 2,4,8 and 10 o’clock positions ● 1-2 mm parallel to the limbus ● Clear margin between infiltrates and limbus ● Can lead to formation of marginal ulcer ● Findings of blepharitis present ● Course : Subepithelial infiltrates separated by clear zone → Spreads circumferentially → Bridging vascularisation → Resolution Management : ● Topical steroids ● Treatment of associated blepharitis www.ophthalmobytes.com Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #marginalkeratitis #keratitis #cornea #cornealulcer #staphylococcus #blepharitis
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