this two and half yrs old kid came to me one month back with complaint of redness,pain,loss of vision, excessive watering.A diagnosis of fungal corneal ulcer with hypopyon was made and treated accordingly,pt responded very well ulcer healed but as on today pt have macular grade central opacity ..... kindly give your opinions on further course of treatment to be followed...



Rx : If ulcer has completely healed , steroid e/drops qid with antifungal cover may be prescribed & pt kept under regular f/up. Opacity will fade to some extent over a period of month or so . Then refractive correction should be prescribed. Opacity will also fade considerably naturally over months to few yrs .

Sir I usually prescribe fleurometholone with anticataract and lubricant drops......nd found a very promising up to 6/9 from 6/60 after post ulcer corneal opacity....

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1st give low dose steroid wits anti fungal drops with cyclgyl eye drops or dark glasses wait for sometime at least 2 month ,ifopacity persists rotational graft advised

There are so many well experienced Ophthalmologists are here.... kindly share your experiences ....we may come across some conclusive treatment on this potential visual morbidity...

@Dr. Praveen Kumar Singh How much did the opacity fade & after how much time?

Superficial to Dense involving mid of corneal stroma respond very well....young boy with recurrent viral ulcer with hand movement vision responded very well to final outcome 6/9....I went for ant segment OCT to see the extent and Depth of scar was variable depth in this case..... total time taken was 3 nd 1/2 month.....

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Pulsatilla (P) 6, Staphysagria 6 (pain), calcar iodide 6 (recurrent), belladonna 30 (swelling of pain), gelsimium 30, causticum 6 (eyes not open)

Now a days viral conjunctivitis is getting endemic always examine cornea under slit lamp to rule out keratitus as most of time it is viral keratoconjuctivitus. Always keep a track of visual acuity.

I fully agree with Dr Harshad Gajjar

Considering age of child monthly follow up for vision testing, refraction under cycoplegia base line and avoid amblyopia.

Already on same lines but unable to know the status of vision in 2 and half yrs old boy from rural illiterate background....

very educative thank u all