How are corneal ulcers and ulcerative keratitis treated in the emergency department (ED)?

Updated: Nov 08, 2018
  • Author: Jesse Borke, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Consulting with an ophthalmologist from the ED is the best practice whenever a corneal ulcer is identified. Because of its potential to permanently impair vision or progress to perforation and an open globe, a corneal ulcer is considered an ophthalmologic emergency.

Although most community-acquired cases of bacterial keratitis resolve with empiric therapy and are managed without cultures, cultures are indicated in cases that involve a corneal infiltrate that is central, large, and extends to the middle to deep stroma, cases that are unresponsive to antibiotic therapy, and cases that have atypical clinical features suggestive of fungal, amoebic, or mycobacterial keratitis. [8]


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