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Corneal eye disease

In this article, a selection of corneal conditions is presented. Practitioners should consider the case history, delve into the sources of reference for background reading and answer the accompanying MCQs.

Image A

image a

A 60-year-old woman has a history of herpes simplex keratitis and has been receiving prolonged topical treatment. She presented for a review appointment of her corneal condition. 

01 What is the most likely diagnosis? 

a) Mooren’s ulcer
b) Phlyctenulosis
c) Ocular non-nephropathic cystinosis 
d) Neurotrophic ulcer 

02 Which of the following is typically associated with this lesion?

a) Pain
b) Hypoesthesia 
c) Rose bengal corneal staining 
d) Itching 

03 Which of the following options would not be considered in the treatment of this condition? 

a) Preservative-free artificial tears
b) Punctal occlusion 
c) Tarsorrhaphy
d) Conjunctiva-Müller resection 

Image B

image b

A 42-year-old fair-skinned woman presents with chronic facial acne, ocular history of chronic posterior blepharitis and conjunctivitis. Image C shows the appearance of her right eye on slit lamp examination. 

04 Considering the history and appearance in Image B, what is the most likely diagnosis?

a) Ocular cicatricial pemphigoid
b) Atopic keratoconjunctivitis 
c) Ocular rosacea
d) Stevens-Johnson syndrome 

05 What is this disorder caused by? 

a) Idiopathic
b) Type II hypersensitivity reaction
c) Type I hypersensitivity reaction 
d) Staphylococcal blepharitis 

06 Which of the following would be most appropriate in the management of this condition?

a) Tetracycline
b) Corticosteroid 
c) Cyclophosphamide
d) Angiotensin converting enzyme inhibitor 

Image C

image c

07 What is the most likely diagnosis of this corneal disorder?

a) Infectious keratitis
b) Haematocornea (corneal blood staining) 
c) Lisch corneal dystrophy 
d) Corneal leukoma 

08 What is the most likely aetiology? 

a) Hyphema and high intraocular pressure 
b) Corneal ulcer
c) Diabetic retinopathy

d) Intermediate uveitis 

09 Which of the following would be considered in the management of this condition? 

a) Phototherapeutic keratectomy (PTK) 
b) Urgent deep anterior lamellar keratoplasty (DALK)  
c) Topical corticosteroids and anti-viral therapy  
d) Watchful waiting until cornea clears without treatment 

Image D


10 Which one of the following is evident in image D? 

a) Limbal phlycten 
b) Corneal infiltrate 
c) Hypopyon 

d) Corneal dellen 

11 The patient is a contact lens wearer, which of the following organisms is most likely to be isolated?  

a) Microsporidia sp. 
b) Pseudomonas aeruginosa  
c) Aspergillus fumigatus 
d) Acanthamoeba sp. 

12 Considering the likely diagnosis and offending organism, which one of the following drugs would be considered as part of the management? 

a) Natamycin  
b) Itraconazole 
c) Fluoroquinolone 
d) Aciclovir 

About the authors

Eirini Skiadaresi MD, MSc, FEBO, is an ophthalmologist within the ABM University Health Board and a fellow of the European Board of Ophthalmology. Miguel González-Andrades MD, PhD, is an ophthalmologist based in Schepens Eye Research Institute, Harvard Medical School. María del Carmen González Gallardo MD, is an ophthalmologist at the University Hospital San Cecilio, Granada. Colm McAlinden MB BCh, BSc (Hons), MSc, PhD, is a visiting professor at the School of Ophthalmology and Optometry, Wenzhou Medical University. 


  1. University of Iowa Health Care 
  2. National Center for Biotechnology Information 
  3. Medscape 
  4. Review of Optometry 
  5. Royal College of Ophthalmology

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