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Ophthalmology Case

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Feb 18, 2013.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    what is your medical diagnosis ?

    Ophthalmology Cases.jpg
     

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  2. neo_star

    neo_star Moderator

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    Dendritic ulcer in the cornea showing up with fluoresceine dye under uv light - Herpetic Corneal Ulcer due to Herpes Simplex virus.

    Diagnosis - Herpes Simplex Keratitis
     

  3. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    Herpes simplex keratitis.
     

  4. apparat

    apparat Well-Known Member

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    Aciclovir stat
     

  5. neo_star

    neo_star Moderator

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    oral or topical ?

    At my institute, we had better success with idoxuridine 0.1 % eyedrops ( 1hourly during day and 2 hourly at night - till healing occurs ) vis a vis acyclovir 3% ointment - 5 times a day till ulcer heals.
     

  6. apparat

    apparat Well-Known Member

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    Topical - highly doubt we have idoxuridine ED here (we have it with lignocaine in a cold sore topical product); and if its to be applied hourly, then likely the adherence/implementation of will be poor. The other one I've heard of, but again don't use, is foscarnet in this diagnosis
     

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  7. neo_star

    neo_star Moderator

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    0.5 % idoxuridine eyedrops can be applied every 5 hourly, but the patient has to buy it from outside...and they think that it's their right to avail of the full hospitality of the government services and that we ( the medical team ) r trying to shy away from our responsibilities by offering the 0.5 % option. So i do the reverse ...while awake every 2 hours and while asleep every 45 minutes. Within a day most fetch the 0.5 % drops.

    Haven't tried foscarnet eyedrops for this indication...so don't know how it compares.

    (Y)
     

  8. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Herpes Simplex Keratitis
     

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