Using dry eye treatments for sick corneas
We have all attended numerous lectures on treating dry eye. We are all comfortable treating red, burning, tearing eyes. Did you ever consider that those tools in your dry eye arsenal are also good for acutely sick eyes? I recently had a patient who drove this point home…even to my ophthalmology partner.
Not a good day
Recently, a local optometrist referred a gentleman to my associate for evaluation of an abrasion that would not heal. The gentleman had a long-standing history of stem cell failure, and now he had an abrasion. My associate thought that the abrasion had become infected and started treatment with a fluoroquinolone.
I saw him two days later. Pain and redness had increased, and stromal involvement was significant with widespread edema and inability to discern the iris. I vividly remember Dr. Paul Ajamian told me as an intern that this was bad.
Vision was counting fingers on acuity testing. I do not like days when my patient can see only fingers. This is not a good day, and thankfully they happen only about twice a month. The keratoepithelial defect was, unfortunately, huge with a central round stromal infiltrate.