1 Its Dendritiform Keratopathy Haters l Dendritiform keratopathy
- Slides: 66
1 It’s Dendritiform Keratopathy, Haters l Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds EBV Soft CL wear Adenovirus Thygeson’s EBMD Subepithelial de posits Mnemonic forthcoming…
2 It’s Dendritiform Keratopathy, Haters l Dendritiform keratopathy: DDx l l l l l H A T E S The Cornea H A T E S, H A T E Sub-epi deposits Dendrites!
3 Q l It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l H A T E S The Cornea Start with these, and work down both ‘hates’ H A T E S, H A T E Sub-epi deposits Dendrites!
Q/A l 4 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l HSV A T E S HZO A T E S The Cornea HSV A T E S, HZO A T E Sub-epi deposits Dendrites!
Q/A l 5 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba T E S HZO Adenovirus T E S The Cornea HSV Acanthamoeba T E S, HZO Adenovirus T E Sub-epi deposits Dendrites!
Q/A l 6 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds E S HZO Adenovirus Thygeson’s E S The Cornea HSV Acanthamoeba Topical meds E S, HZO Adenovirus Thygeson’s E Sub-epi deposits Dendrites!
Q/A l 7 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds EBV S HZO Adenovirus Thygeson’s EBMD S The Cornea HSV Acanthamoeba Topical meds EBV S, HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A l 8 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear, HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 9 It’s Dendritiform Keratopathy, Haters The dendrites of herpetic epitheliopathy take stains in a particular manner: words The epithelium at the edges of the dendrite stain with rosetwobengal , while one word the base of the dendrite stains with fluorescein. It’s important to note that the dendrites associated with these other conditions will generally not take stains the same way. The Cornea Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HSV Acanthamoeba Topical meds EBV Soft CL wear, HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A l 10 It’s Dendritiform Keratopathy, Haters The dendrites of herpetic epitheliopathy take stains in a particular manner: The epithelium at the edges of the dendrite stain with rose bengal , while the base of the dendrite stains with fluorescein. It’s important to note that the dendrites associated with these other conditions will generally not take stains the same way. The Cornea Dendritiform keratopathy: DDx l l l l l HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HSV Acanthamoeba Topical meds EBV Soft CL wear, HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 11 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds l EBV What two classes of meds are especially likely to produce a dendritiform keratitis? Soft CL wear Thisl class is an CL anti-infective: Soft wear Antivirals l This class is an ocular hypotensive: Beta-blockers l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A l 12 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds l EBV What two classes of meds are especially likely to produce a dendritiform keratitis? Soft CL wear Thisl class is an CL anti-infective: Soft wear l This class is an ocular hypotensive: l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 13 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds l EBV What two classes of meds are especially likely to produce a dendritiform keratitis? Soft CL wear Thisl class is an CL anti-infective: Soft wear Antivirals l This class is an ocular hypotensive: Beta-blockers l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 14 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx HSV l Acanthamoeba l Topical meds What specifically about soft CL wear is the culprit? l EBVthimerosal in the CL solution The preservative l Soft CL wear l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A l 15 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx HSV l Acanthamoeba l Topical meds What specifically about soft CL wear is the culprit? l EBVthimerosal in the CL solution The preservative l Soft CL wear l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 16 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
Q/A l 17 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l two words same two words H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
A l 18 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
Q l 19 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
A l 20 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
Q l 21 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
A l 22 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Inlwhat key way do the dendrites of Acanthamoeba keratitis differ from those of HSV EBV keratitis? HSV dendrites usually have terminal bulbs , whereas Acanthamoeba Soft CLdendrites wear don’t. Be sure l Soft CL wear to evaluate any dendritic keratitis carefully for the presence/absence of terminal bulbs ! l H A T E Sub-epi deposits ZO keratitis patient differ In what key way might the presenting complaint of an Acanthamoeba from that of an HSV keratitis patient? denovirus l patient with Acanthamoeba keratitis will complain of pain that seems out of proportion to The the clinical picture, while the HSV keratitis patient will have lesshygeson’s pain than would be expected given l the appearance of the cornea. BMD HZO Adenovirus Why Acanthamoeba keratitis so painful? l is Thygeson’s Because the bug has a propensity for perineural invasion l EBMD l Subepithelial deposits Dendrites!
23 Q It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
24 A It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
25 Q It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
26 A It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
27 Q It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
28 A It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
29 Q It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
30 A It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD Sub-epi deposits l Thygeson’s l l EBMD Subepithelial deposits Dendrites!
31 Q It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD What are the ‘ 6 F’s’ of EBMD? Sub-epi deposits l Thygeson’s l l --F Dendrites! --Five to F --Fibrillar material accumulates under the basement membrane EBMD Subepithelial deposits
32 A It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx In this context, what does EBMD stand for? l The Cornea HSV What are three other common names for EBMD? l Acanthamoeba HSV --Map-dot-fingerprint dystrophy --Cogan’s microcystic dystrophy Acanthamoeba l Topical medsdystrophy --Anterior basement membrane Topical meds What slit-lamp appearance of EBMD? lis the EBV It can present in any combo of the following: Softthe. CLsame wear --Fingerprint lines: Thin, curvy lines that occur in groups and follow course l Soft CL wear --Map lines: Thicker lines that follow a more jagged course Epithelial basement membrane dystrophy l --Dots/cysts HZO What do pts complain of? Adenovirus l HZO Most cases present with symptoms related to recurrent epithelial erosions (REE) Thygeson’s l Adenovirus EBMD What are the ‘ 6 F’s’ of EBMD? Sub-epi deposits l Thygeson’s l l --Female --Fifties and older (usually) Dendrites! --Five to Fifteen percent of the population are afflicted --Fifty percent of pts who suffer REE have it --Fibrillar material accumulates under the basement membrane EBMD Subepithelial deposits
Q l 33 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l HSV Acanthamoeba Topical meds EBV Soft CL wear The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits HZO l Adenovirus l Thygeson’s What does this mean, sub-epi deposits? Dendrites! Deposits as found in diseases such as Fabry’s, as well as with certain systemic drugs l EBMD l Subepithelial deposits l
A l 34 It’s Dendritiform Keratopathy, Haters Dendritiform keratopathy: DDx l l l HSV Acanthamoeba Topical meds EBV Soft CL wear The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits HZO l Adenovirus l Thygeson’s What does this mean, sub-epi deposits? Dendrites! Deposits as found in diseases such as Fabry’s, as well as with certain systemic drugs l EBMD l Subepithelial deposits l
Q l 35 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the l l l l l association especially weak? HSV? Acanthamoeba? Topical meds? EBV? Soft CL wear? HZO? Adenovirus? Thygeson’s? EBMD? Subepithelial deposits? The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A l 36 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the l l l l l association especially weak? HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits The Cornea HSV Acanthamoeba Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 37 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx ? l Follicular conjunctivitis ? l l l l l Fever (PCF) Epidemic ? Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba What are three adenoviral ocular syndromes? Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A 38 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis l l l l l Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba What are three adenoviral ocular syndromes? Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 39 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis? Fever (PCF) ? Epidemic Keratoconjunctivitis (EKC)? The Cornea HSV l Acanthamoeba HSV Acanthamoeba the three, which is the only one with significant corneal involvement? l Of Topical meds l EBV Soft CL wear l l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A 40 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea HSV (Unsurprisingly, it’s the one with ‘kerato’ in its name) l Acanthamoeba HSV Acanthamoeba the three, which is the only one with significant corneal involvement? l Of Topical meds l EBV Soft CL wear l l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 41 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds There’sla good chance that, in your time as an ophthalmologist, EBV you haven’t seen adenoviral follicular conjunctivitis. Why is that? Because is so mild, so transient, that sufferers do not Soft CL wear l it Soft CLandwear l bother to come in for treatment l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A 42 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis l HSV Mild disease, rarely seen in clinic l Acanthamoeba Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba l Topical meds There’sla good chance that, in your time as an ophthalmologist, EBV you haven’t seen adenoviral follicular conjunctivitis. Why is that? Because is so mild, so transient, that sufferers do not Soft CL wear l it Soft CLandwear bother to come in for treatment l l l HZO Adenovirus Thygeson’s EBMD Subepithelial deposits HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 43 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis l HSV Mild disease, rarely seen in clinic l Acanthamoeba l l l l Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba Topical meds How does pharyngoconjunctival fever present? EBV With a follicular conjunctivitis accompanied EBVby HA, fever (check the name), and pharyngitis (ditto) Soft CL wear Because of its manifestations, with what common HZO systemic condition is it sometimes confused? Adenovirus The flu HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Thygeson’s EBMD Sub-epi deposits Dendrites!
A 44 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea l HSV Mild disease, rarely seen in clinic l Acanthamoeba Follicular conjunctivitis +HSV Acanthamoeba l Topical meds. HA + fever + pharyngitis Topical meds How does pharyngoconjunctival fever present? l EBV With a follicular conjunctivitis accompanied EBVby HA, fever (check the name), and pharyngitis (ditto) Soft CL wear l l l Because of its manifestations, with what common HZO systemic condition is it sometimes confused? Adenovirus The flu HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 45 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea l HSV Mild disease, rarely seen in clinic l Acanthamoeba Follicular conjunctivitis +HSV Acanthamoeba l Topical meds. HA + fever + pharyngitis Topical meds How does pharyngoconjunctival fever present? l EBV With a follicular conjunctivitis accompanied EBVby HA, fever (check the name), and pharyngitis (ditto) Soft CL wear l l l Because of its manifestations, with what common HZO systemic condition is it sometimes confused? Adenovirus The flu HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Thygeson’s EBMD Sub-epi deposits Dendrites!
A 46 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) Epidemic Keratoconjunctivitis (EKC) The Cornea l HSV Mild disease, rarely seen Looks like the flu in clinic l Acanthamoeba Follicular conjunctivitis +HSV Acanthamoeba l Topical meds. HA + fever + pharyngitis Topical meds How does pharyngoconjunctival fever present? l EBV With a follicular conjunctivitis accompanied EBVby HA, fever (check the name), and pharyngitis (ditto) Soft CL wear l l l Because of its manifestations, with what common HZO systemic condition is it sometimes confused? Adenovirus The flu HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Thygeson’s EBMD Sub-epi deposits Dendrites!
Q 47 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) l HSV Mild disease, rarely seen Looks like the flu in clinic l Acanthamoeba l l l l Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba Topical meds EBV keratoconjunctivitis present? How does epidemic In stages… Soft CL wear Stage 1: Stage 2: Stage 3: HZO Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A 48 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) l HSV Mild disease, rarely seen Looks like the flu in clinic l Acanthamoeba l l l l Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba Topical meds EBV keratoconjunctivitis present? How does epidemic In stages… Soft CL wear Stage 1: Upper respiratory tract infection Stage 2: HZO Stage 3: Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A 49 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) l HSV Mild disease, rarely seen Looks like the flu in clinic l Acanthamoeba l l l l Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba Topical meds EBV keratoconjunctivitis present? How does epidemic In stages… Soft CL wear Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
A 50 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx l Follicular conjunctivitis Fever (PCF) l HSV Mild disease, rarely seen Looks like the flu in clinic l Acanthamoeba l l l l Topical meds EBV Soft CL wear HZO Adenovirus Thygeson’s EBMD Subepithelial deposits Epidemic Keratoconjunctivitis (EKC) The Cornea HSV Acanthamoeba Topical meds EBV keratoconjunctivitis present? How does epidemic In stages… Soft CL wear Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
51 Q It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
52 A It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
53 Q It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear … l Soft CL wear l Follicular conjunctivitis … …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A 54 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis … …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A 55 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q/A 56 It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
57 Q It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
58 A It’s Dendritiform Keratopathy, Haters Pharyngoconjunctival Dendritiform keratopathy: DDx Epidemic Keratoconjunctivitis (EKC) Fever (PCF) The Cornea l HSV Mild disease, rarely seen Bilateral follicular conj’itis + Looks like the flu punctate keratopathy + in clinic l Acanthamoeba HSV petechial hemorrhages + conj membranes + A canthamoeba Topical meds lymphadenopathy What will l pts complain of at this stage? T opical meds Tearing, foreign-body sensation, photophobia l EBV keratoconjunctivitis present? How does epidemic Slit-lamp exam of the anterior segment will reveal… In stages… Soft CL wear …Punctate l epithelial Soft keratopathy CL wear l Follicular conjunctivitis …Sub-conj heme …Conjunctival membranes HZO Adenovirus Thygeson’s EBMD Subepithelial deposits What nonocular sign might be found? l Preauricular lymphadenopathy l l Stage 1: Upper respiratory tract infection Stage 2: Severe follicular conjunctivitis HZO Stage 3: Subepithelial infiltrates Adenovirus Thygeson’s EBMD Sub-epi deposits Dendrites!
Q l 59 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Adenovirus Thygeson’s … EBMD Subepithelial deposits Thygeson’s EBMD Sub-epi deposits Dendrites!
A l 60 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
Q l 61 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
A l 62 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
Q l 63 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
A l 64 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds What is the complete name of the condition listed here as simply ‘Thygeson’s’? Topical meds Thygeson’s superficial punctate keratitis l EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
Q l 65 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Will theispt’s mild, or in nature? What thecomplaints completebename of severe the condition listed here as simply ‘Thygeson’s’? T opical meds Like those withsuperficial Acanthamoeba keratitis, Thygeson’s pts will complain Thygeson’s punctate keratitis l EBV of pain that seems out of proportion to the clinical picture EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
A l 66 It’s Dendritiform Keratopathy, Haters The strength-of-association with dendritiform lesions is not the Dendritiform keratopathy: DDx same for all of these conditions. For which three conditions is the association especially weak? The Cornea HSV l Acanthamoeba HSV Acanthamoeba l Topical meds Will theispt’s mild, or in nature? What thecomplaints completebename of severe the condition listed here as simply ‘Thygeson’s’? T opical meds Like those withsuperficial Acanthamoeba keratitis, Thygeson’s pts will complain Thygeson’s punctate keratitis l EBV of pain that seems out of proportion to the clinical picture EBV What do Thygeson’s pts c/o? Soft CL wear l Soft CL wear Photophobia and foreign-body sensation l HZO What is the classic corneal finding on exam (hint: it’s not dendritiform lesions)? Adenovirus Multiple discrete punctate lesions l l l HZO Thygeson’s Adenovirus EBMD Sub-epikeratitis deposits Thygeson’s superficial punctate Dendrites! EBMD Subepithelial deposits
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