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On inspection with a slit lamp, tiny lumps can be found on the cornea of the eye. These lumps can be more easily seen after applying fluorescein or rose Bengal dye eye-drops. The lumps appear to be randomly positioned on the cornea and they may appear and disappear over a period of time (with or without treatment). TSPK may affect one or both eyes.
Fluorescein is a dye which is taken up by damaged cornea such that the area appears green under cobalt blue light. [3] There is also a version that comes premixed with lidocaine. [4] [8] Fluorescein was first made in 1871. [9] It is on the World Health Organization's List of Essential Medicines. [10]
During eye exam the defect is examined after staining with fluorescein dye. The underlying cornea has minimal inflammation. Patients with epithelial keratitis complain of foreign-body sensation, light sensitivity, redness and blurred vision. Focal or diffuse reduction in corneal sensation develops following recurrent epithelial keratitis.
Diagnosis is mostly based on the symptoms, though several other tests may be used. [8] Dry eye syndrome occasionally makes wearing contact lenses impossible. [2] Treatment depends on the underlying cause. Artificial tears are usually the first line of treatment. Wrap-around glasses that fit close to the face may decrease tear evaporation. [9]
Keratitis is a condition in which the eye's cornea, the clear dome on the front surface of the eye, becomes inflamed. [1] The condition is often marked by moderate to intense pain and usually involves any of the following symptoms: pain, impaired eyesight, photophobia (light sensitivity), red eye and a 'gritty' sensation. [2]
In some, there is a family history of corneal growth disorders which may be progressive with age. Much more commonly, misuse of contact lenses may be a precipitating factor. Whichever, it is always potentially serious and sometimes necessitates urgent treatment and corneal opacities are the fourth leading cause of blindness.
In pure aqueous tear deficiency dry eye patients, fluorescein stains in the interpalpebral exposure zone. In mechanical dry eye patients, fluorescein staining can be seen by pulling down the lower lid spread to the non-exposure zone. A tear-clearance test can also detect irregularities in the tear film. [6]
Corneal ulcer, also called keratitis, is an inflammatory or, more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. [ 1 ] [ 2 ] [ 3 ] It is a common condition in humans particularly in the tropics and in farming. [ 4 ]