Case 8: Corneal Ulcer - The 10 Essentials to Do
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- čas přidán 11. 03. 2021
- Welcome to EMR Rounds! A collection of short case-based discussions on challenging and common scenarios I face in my OPD every day. Watch in 1.25 x to have a better listening experience.
In this crisp video we discuss on the very common condition - Corneal ulcer and the 10 S we must record and perform whenever we examine the patient. A must watch !
Thank you sir for explaining the concept in a very nice way ❤
Thank you for this precise summation, Dr. Pranesh!
Most helpful of all the videos I've watched for insight. Thank you so much!
Your emr round are life savoir, man!! Please add more of them. 😊😊
Thank you so much sir...like always learned a lot...
Thanks
very informative
Your videos are so good
Thank you
Thankyou sir.
awesome
Sir how do we calculate the depth dimensions in mm??
1)Conditions where corneal sensation are lost?
2)Are there any conditions where there is pain in eyes due to corneal disease but corneal sensation is absent?
A. CONGENITAL:
i. Congenital trigeminal anesthesia.
ii. Corneal dystrophies
B. ACQUIRED:
i. Diabetes mellitus: reduces sensitivity.
ii. Herpes simplex keratitis.
iii. Leprosy.
iv. Adie’s tonic pupil
v. Myasthenia gravis.
vi. Toxic corneal hypoesthesia:
C. PHYSIOLOGICAL:
i. Iris color-lighters the iris color, more the sensitivity.
ii. Gender-more sensitive in males than females.
iii. Eyelid closure: decreases sensitivity. This is due to depressed acetylcholine levels with lid close. This is the reason for low corneal sensitivity in morning after a night’s sleep.
D. PHARMACOLOGICAL:
i. Surface anesthetics like 4% lignocaine, 0.5% proparacaine.
ii. Beta blockers-temporary decrease.
iii. Sodium sulfacetamide-30% solution decreases sensitivity.
iv. Atropine-decreases sensitivity after 10 minutes of instillation. This is due to decreased acetylcholine.
E. HORMONAL:
i. Preovulatory reduction in corneal sensations due to estrogen rise.
ii. Decreased corneal sensitivity during pregnancy.
F. MECHANICAL:
i. Contact lens: decreases corneal sensitivity. This may be attributed to the decrease in oxygen pressure at epithelial level.
G. SURGICAL:
i. Limbal incisions
ii. Corneal grafts
iii. Refractive surgeries: LASIK decreases sensations.
iv. Other procedures: Photocoagulation and retinal detachment surgeries.
v. Trigeminal denervation
@@pranesh thank you sir , what is the answer for 2nd question??
The second Q more or less reflects the 1st. Any corneal lesion should induce pain but if the corneal nerves are bad in quantity/ quality the pt cannot perceive the sensation.
To give an answer, I feel the viral keratitis and systemic diseases like DM will cause pt not to perceive the pain despite the lesion
@@pranesh thank you sir 🙏🙏
Is there any whatsapp or telegram grp?
Nope :) FB page is ther - Facebook.com/ophthalcrux