Hypopyon corneal ulcer

 

Hypopyon Corneal Ulcer

Urgent Ocular Condition: NEET PG High-Yield

A hypopyon corneal ulcer is an infectious keratitis associated with the accumulation of inflammatory cells (pus) in the anterior chamber.

1. Pathogenesis & Etiology

The hypopyon is sterile in many cases, resulting from the diffusion of toxins from the corneal ulcer into the anterior chamber, triggering an inflammatory cascade.

  • Most Common Organism: Streptococcus pneumoniae.
  • Other Causes: Pseudomonas aeruginosa, Staphylococcus aureus, and Fungi (often associated with vegetative trauma).

2. Clinical Features

Feature Clinical Note
Symptoms Severe pain, photophobia, blurred vision, and mucopurulent discharge.
Signs Corneal epithelial defect (fluorescein stain positive), ciliary injection, and a fluid level of pus (hypopyon) in the anterior chamber.

3. NEET PG High-Yield Pearls

  • Treatment: Requires immediate hospitalization and intensive topical antibiotic therapy (fortified antibiotics like Ceftazidime and Vancomycin).
  • Contraindication: Topical steroids are strictly contraindicated until the infection is under control, as they can exacerbate the ulcer and promote perforation.
  • Differential: Must distinguish from endophthalmitis (which involves the entire vitreous cavity).
  • Resource: For clinical diagrams and high-yield question banks, visit mymedschool.org.