What are the clinical manifestations of the diabetic corneal alterations and their management ?

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Recurrent epithelial erosions (REE), corneal edema, decreased corneal sensations, delayed epithelial healing, adenoviral keratoconjunctivitis (less immunity) Neurotrophic keratitis Rx - diabetic control, diet REE - lubricants, epi debridement, eye patching, BCL, antibiotic ointment Anterior stromal puncture (recalcitrant cases) Neurotrophic - artificial tears (PF), topical aldose reductase, topical nerve growth factors In DM - use topical steroid with caution
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Corneal manifestation of diabetes Corneal edema Decreased corneal nerve sensation Frequent punctate epithelial erosions Keratitis Measures to control :- Strict glycemic control Treating of dry eye disease Antibiotic eye drops
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Protinase and growth factor alterations Altered epithelial basement interactions with decreased formation of hemidesmosomes Delayed wound healing Alteration in corneal nerves and stem progenitor cells
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TH THEY ARE INCREASED CENTRAL CORNEAL THICKNESS ALTERED COOLAGEN STRUCTURE IN THE STROMA DEPOSITION OF B M COMPISITION CROSS CORNEAL LINKAGE
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AS AN OPHTHALMOLOGIST WE SHOULD BE ALSO AWARE OF THE POSSIBLE COMPLECATIONS OF LONG STANDING UNCONTROLLED D M THEY ARE DIABETIC RETINOPA D NEUROPATHY D NEPHROPATHY D ARTHOPATHY D DERMOPATHY PERIDONDITIS DIAETIC PATIENTS ARE PRONE TO C V S AND C N S DISORDERS DIABETIC ULCERS AND FOOT DEMENTIA ALZEMERS IN PESENCE OF NEPHROPATHY REIOPATHY IS SEVERE
In diabetic patients due to neuropathy there is increased chances of corneal injury, also leading to delayed wound healing, oedema, tear change, infection and keratizations. Managnent depends on which complications patient is having.

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