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.
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
c) Ocular non-nephropathic cystinosis
d) Neurotrophic ulcer
02 Which of the following is typically associated with this lesion?a) Pain
c) Rose bengal corneal staining
03 Which of the following options would not be considered in the treatment of this condition?a) Preservative-free artificial tears
b) Punctal occlusion
d) Conjunctiva-Müller resection
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
d) Angiotensin converting enzyme inhibitor
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?
d) Intermediate uveitis
09 Which of the following would be considered in the management of this condition?
10 Which one of the following is evident in image D?
d) Corneal dellen
11 The patient is a contact lens wearer, which of the following organisms is most likely to be isolated?
12 Considering the likely diagnosis and offending organism, which one of the following drugs would be considered as part of the management?
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.