By Arthur Lim Siew Ming and Ian J Constable (Auth.)
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Extra resources for Colour Atlas of Ophthalmology
15 Severe Pseudomonas pyocyaneus corneal ulcer. Fig. 16 Central pneumococcal corneal ulcer with hypopyon (pus in anterior chamber). 46 Corneal Dystrophy Fig. 17 Hereditary corneal dystrophy. Fig. 18 Fuch's corneal dystrophy with diffuse corneal oedema. Fig. 19 Keratoconus with conical cornea and opacity at apex. 47 Corneal Opacity 48 Fig. 20 Slit picture of interstitial keratitis showing stromal thickening, opacity with abnormal corneal vessels. Fig. 21 Corneal opacity caused by herpes simplex infection (disciform keratitis).
All relatives of patients with chronic open-angle glaucoma should be regularly reviewed. Treatment is usually medical. The therapy of choice is Pilocarpine 4 times a day or Timolol 0 . 2 5 % - 0 . 5 % twice a day. Additional drugs include 1 % - 2 % Adrenalin, Propine 1 % and oral Acetazolamide. If medical therapy proves unsatisfactory then laser trabeculoplasty may be used. This is effective in the majority of cases. But if it is not effective then microsurgical trabeculectomy should be considered.
Examination usually shows no abnormality. Investigations should be carried out to exclude specific causes such as inturned lashes (trichiasis), defective tear flow (dry-eye), chronic allergy or eyelid infection (blepharitis). 34 Treatment depends on identification of contributory factors and use of artificial tears, antihistamine drops and sometimes weak vasoconstrictors. Antibiotics and steroids should not be used. The condition tends to persist despite treatment and patient requires frequent reassurance.
Colour Atlas of Ophthalmology by Arthur Lim Siew Ming and Ian J Constable (Auth.)