Feature of fungal corneal ulcer is/are all except:
Question Category:
Correct Answer:
Flat and mobile hypopyon
Description:
C. Flat and mobile hypopyonThe hypopyon, if present, is thick and immobile, and may even have a convex upper surface- Parson 22nd/199"Common symptoms of a patient with a fungal keratitis may include pain, photophobia, conjunctival injection, tearing, discharge (usually mucopurulent) and foreign-body sensation'- www.healio.comMycotic Corneal Ulcer Khurana 6th/106-07The incidence of suppurative corneal ulcers caused by fungi has increased in the recent years due to injudicious use of antibiotics and steroids.The fungi more commonly responsible for mycotic corneal ulcers are Aspergillus (most common), Candida and FusariumSymptoms are similar to the central bacterial corneal ulcer, but in general they are less marked than the equal-sized bacterial ulcer and the overall course is slow and torpid.Signs: A typical fungal corneal ulcer has following salient featuresCorneal ulcer is dry-looking, greyish white, with elevated rolled out marginsDelicate feathery finger-like extensions are present into the surrounding stroma under the intact epithelium.A sterile immune ring (yellow line of demarcation) may be present where fungal antigen and host antibodies meetMultiple, small satellite lesions may be present around the ulcer.Usually a big hypopyon is present even if the ulcer is very small. Unlike bacterial ulcer, the hypopyon may not be sterile as the fungi can penetrate into the anterior chamber without perforation.Perforation in mycotic ulcer is rare but can occur.Corneal vascularization is conspicuously absent.Fungal Corneal Ulcer Parson 22nd/201Symptoms are much milder than the clinical signs would suggest. The slough in these ulcers is dry in appearance with feathery borders, surrounded by a yellow line of demarcation which gradually deepens into a gutter and there may also be a hypopyonAn immune ring (Wesseley) may be visible due to deposition of immune complexes and inflammatory cells around the ulcer. Satellite lesions may also be seen.There is marked ciliary and conjunctival congestion, but symptoms of pain, watering and photophobia are disproportionately less as compared to those in cases of bacterial corneal ulcers.Bacterial corneal ulcer: accumulation of purulent exudate on the cornea- Khurana 6th/ 100
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