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DESCRIPTION: A term used to define a wide variety of corneal infections, irritations, and inflammations; since each type of condition is unique, medical diagnosis and treatment is essential. Corneal ulcers are commonly caused by bacterial or fungal invasions following superficial corneal abrasions; among the common infectious agents are: staphyloccus, streptococcus, herpes (both simplex and zoster), adenovirus, rubeola, rubella, mumps, trachoma, infectious mononucleosis, and pneumococcus; also at fault may be Vitamin A deficiency or broad spectrum antibiotic drug reactions. Corneal ulcers may also follow trauma, may be associated with other eye infections (e.g., conjunctivitis), may be related to other corneal disorders (e.g., degenerative conditions, or ptosis, which may cause a "dry eye"), or may arise from a variety of systemic disorders (especially those of autoimmune origin). Symptoms of corneal infection include extreme pain and photophobia.

TREATMENT: Medical treatment is absolutely essential - even a delay of a few hours can affect the ultimate visual result. The causative factors must be determined through laboratory analysis of scrapings; medical treatment (i.e., medication) varies according to the cause.

IMPLICATIONS: It is extremely important to treat keratitis before corneal tissue is destroyed and scar tissue is formed. Because the pain is so severe in keratitis, the patient usually welcomes medical attention. However, if the cornea loses its sensitivity (as in trauma, surgery, or damage to the trigeminal nerve), ulcers can develop without accompanying pain.

The implications for personal hygiene are evident, especially with children. Handwashing during periods of illness and following toileting is of vital importance as a preventive measure.

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