eMedicine Specialties > Ophthalmology > Cornea

Ulcer, Corneal: Follow-up

Author: Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Contributor Information and Disclosures

Updated: Apr 21, 2006

Follow-up

Further Inpatient Care

  • Inpatient care for patients with corneal ulcers is not required.

Further Outpatient Care

  • Outpatient care for patients with corneal ulcers is necessary only if systemic manifestations are present.

Complications

  • The most serious complications for these patients are systemic because, in many cases, their underlying conditions are associated with a high mortality rate.
  • The most serious ocular complication includes corneal perforation with secondary infections, corneal scarring, and secondary cataracts and glaucoma.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Patients with an undiagnosed corneal ulcer must be referred to a rheumatologist because the underlying diagnosis could have significant implications for their general health and life, and the ophthalmologist should be careful not to overlook such an underlying diagnosis.

Special Concerns

  • Because of the possibility of recurrence, any later surgical interventions should be performed with concurrent immunosuppression, even in apparently quiet eyes.
 


More on Ulcer, Corneal

Overview: Ulcer, Corneal
Differential Diagnoses & Workup: Ulcer, Corneal
Treatment & Medication: Ulcer, Corneal
Follow-up: Ulcer, Corneal
References
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References

  1. Asai T, Nakagami T, Mochizuki M. Three cases of corneal melting after instillation of a new nonsteroidal anti-inflammatory drug. Cornea. Feb 2006;25 (2):224-7. [Medline].

  2. Bullen CL, Liesegang TJ, McDonald TJ, DeRemee RA. Ocular complications of Wegener''s granulomatosis. Ophthalmology. Mar 1983;90(3):279-90. [Medline].

  3. Flach AJ. Corneal melts associated with topically applied nonsteroidal anti-inflammatory drugs. Trans Am Ophthalmol Soc. 2001;99:205-10; discussion 210-2. [Medline].

  4. Foster CS, Forstot SL, Wilson LA. Mortality rate in rheumatoid arthritis patients developing necrotizing scleritis or peripheral ulcerative keratitis. Effects of systemic immunosuppression. Ophthalmology. Oct 1984;91(10):1253-63. [Medline].

  5. Guidera AC, Luchs JI, Udell IJ. Keratitis, ulceration, and perforation associated with topical nonsteroidal anti-inflammatory drugs. Ophthalmology. May 2001;108(5):936-44. [Medline].

  6. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. Sep 1997;40(9):1725. [Medline].

  7. Jayson MI, Jones DE. Scleritis and rheumatoid arthritis. Ann Rheum Dis. Jul 1971;30(4):343-7. [Medline].

  8. Lambiase A, Rama P, Bonini S, et al. Topical treatment with nerve growth factor for corneal neurotrophic ulcers. N Engl J Med. Apr 23 1998;338(17):1174-80. [Medline].

  9. Lambiase A, Bonini S, Aloe L, et al. Anti-inflammatory and healing properties of nerve growth factor in immune corneal ulcers with stromal melting. Arch Ophthalmol. Oct 2000;118(10):1446-9. [Medline].

  10. Paroli MP, Pinca M, Speranza S. Paracentral corneal melting in a patient with Vogt-Koyanagi-Harada's syndrome, psoriasis, and Hashimoto's thyroiditis. Ocul Immunol Inflamm. Dec 2003;11(4):309-13. [Medline].

  11. Robin JB, Schanzlin DJ, Meisler DM, et al. Ocular involvement in the respiratory vasculitides. Surv Ophthalmol. Sep-Oct 1985;30(2):127-40. [Medline].

  12. Schechter BA, Rand WJ, Nagler RS. Corneal melt after amniotic membrane transplant. Cornea. Jan 2005;24(1):106-7. [Medline].

  13. Vanathi M, Sharma N, Titiyal JS. Tectonic grafts for corneal thinning and perforations. Cornea. Nov 2002;21(8):792-7. [Medline].

  14. West RH, Barnett AJ. Ocular involvement in scleroderma. Br J Ophthalmol. Dec 1979;63(12):845-7. [Medline].

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Further Reading

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Keywords

corneal melt, chronic serpiginous ulcer of the cornea, ulcus rodens, corneoscleral melting

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Contributor Information and Disclosures

Author

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Kilbourn Gordon III, MD, FACEP, Urgent Care Physician, Primary Medical, Huntington Walk-In and Greenwich Convenient Medical Center
Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology, American College of Emergency Physicians, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Ralph Garzia, OD, Assistant Dean for Clinical Programs, Associate Professor, School of Optometry, University of Missouri at St Louis
Ralph Garzia, OD is a member of the following medical societies: American Academy of Optometry and American Optometric Association
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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