Faculty Comments - Vision Change Case 5 - Answer 9:


Question 9: When do you suggest that he follow up?

Answer:


Daily. Not only could the diagnosis be incomplete, but there can be secondary infections.
Further, a herpes simplex keratitis can masquerade as a corneal abrasion. If found early, the herpes virus creates the characteristic dendritiform patterns seen at right, but if left to continue, it may appear like a simple corneal abrasion.
In our case, there is a good history for foreign body. If there isn't, however, it would be advisable to ask about a history of perioral cold sores before completing the visit.

If the problem doesn't resolve, a viral culture of debrided epithelium would be indicated.


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