White Lesion on Cornea

Beeran Meghpara MD

Co-Director of the Refractive Surgery Department
Wills Eye Hospital, Philadelphia

A 31-year-old presents with a 3-day history of pain and photophobia. Vision is 20/30. Why?

cornea coach 022

This image is most consistent with which diagnosis?

  1. Horner’s syndrome
  2. Peripheral corneal ulcer
  3. Granulomatous uveitis
  4. Herpes simplex keratitis

Analysis

The patient was noted to have perilimbal injection and a mild increase in conjunctival vascularity. A small corneal infiltrate is seen at the 3:30 position on the peripheral cornea. There is no overlying epithelial defect and the iris and anterior chamber is clear.

The patient was diagnosed with a small peripheral corneal ulcer suggestive of a staphylococcal infection.

cornea coach 022 analysis

Video Analysis

In this 9-minute video featuring Dr. Beeran Meghpara, co-director of the Refractive Surgery Department at Wills Eye Hospital, you will:

  • Learn when culture a corneal ulcer
  • How to culture a corneal ulcer
  • How to treat a corneal ulcer

Clinical Tip

In a small peripheral ulcer in which the epithelium is intact corneal cultures are not necessary and non-fortified topical antibiotics should be given.