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Central Sterile Corneal Ulceration Workup

  • Author: Saadia Zohra Farooqui, MBBS; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Jun 27, 2016
 

Laboratory Studies

Given the morbidity of missing an infectious ulcer, the importance of performing corneal smears and cultures cannot be overemphasized. Infectious etiologies should be ruled out initially by performing smears and cultures. 

Corneal scraping also is indicated to evaluate for infectious etiologies.

Perform a workup to rule out infectious or systemic inflammatory diseases (eg, collagen vascular, autoimmune) as clinically indicated. Systemic testing (eg, blood work) may be necessary in certain patients. 

The precise stains and cultures depend on clinical suspicion, including the following:

  • Stains - Gram stain, Giemsa, Calcofluor white, acid-fast bacillus (AFB), and Gomori
  • Cultures - Sabouraud agar, blood/chocolate agar, thioglycolate solution, and Page solution (then  Escherichia coli overlay)
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Procedures

If clinically indicated, performing a biopsy of the presumed infectious ulcer is recommended to identify the causative organism.

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Contributor Information and Disclosures
Author

Saadia Zohra Farooqui, MBBS Senior Resident, Singapore National Eye Centre, Singapore General Hospital, Singapore

Disclosure: Nothing to disclose.

Coauthor(s)

C Stephen Foster, MD, FACS, FACR, FAAO, FARVO Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution

C Stephen Foster, MD, FACS, FACR, FAAO, FARVO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, Sigma Xi

Disclosure: Nothing to disclose.

Joseph JK Ma, MD Assistant Professor, Department of Ophthalmology, University of Toronto Faculty of Medicine, Canada

Joseph JK Ma, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

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.

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