EXPOSURE KERATOPATHY

M.GOPIKA

Normally cornea is covered by eyelids during sleep and during awake it is kept moist by the blinking movements . When the eyes are covered insufficiently by the eyelids , there is a loss of protective mechanism ( keratitis lagophthalmos ) then there develops ‘exposure keratopathy ‘

CAUSES:

factors that produce lagophthalmos

Exposure proptosis Bells palsy Ectropion Symblepharon Deep coma Physiological lagophthalmos

PATHOGENESIS: Due to exposure

Corneal epithelium dries up

Dessication (epithelium casts off)

Invasion by infective orgsnisms

CLINICAL FEATURES: SYMPTOMS:

Ocular irritation burning foreign body sensation redness symptoms of causative

agent

SIGNS: Drying of cornea: due to inadequate

blinking

Punctate epithelial defects: develops in the lower third in the region of palpebral fissure

Corneal ulceration: due to necrosis and bacterial superinfection, they may even perforate

TREATMENT : PROPHYLAXIS : Treatment of the

underlying cause artificial tears instillation of ointment

soft bandage contact lens TREATMENT: TARSORRHAPHY by

suturing the lids together

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