BMedSc, MBBS, MBA, PhD, FRANZCO, FRACS, Honorary Clinical Associate Professor, Centre for Eye Research Australia, East Melbourne, Vic; Honorary Clinical Associate Professor, Department of Surgery (Ophthalmology), University of Melbourne, Parkville, Vic; Principal Associate, Eye Surgery Associates, East Melbourne, Vic.
MBChB, MMed, Ophthalmology FEACO, Cornea Fellow, Sydney Eye Hospital, Sydney, NSW.
Aust J Gen Pract. 2022 Nov;51(11):855-860. doi: 10.31128/AJGP-06-22-6453.
Patients frequently present to general practitioners (GPs) with discomfort and a red eye due to corneal ulceration, defined as a defect in the corneal epithelium and underlying stroma. A myriad of conditions may lead to corneal ulcers, and prompt diagnosis and adequate management is needed to prevent visual morbidity.
The aim of this article is to assist clinicians/GPs to 1) determine the likely cause of a corneal ulcer and 2) understand the management of corneal ulcers, including the timing of referral to an ophthalmologist.
Corneal ulcers are typically painful and reduce vision. A good understanding of the clinical presentation of corneal ulcers can aid diagnosis and guide treatment. Urgent referral of trauma and infectious keratitis to an ophthalmologist can prevent endophthalmitis and loss of vision and/or the eye. GPs can play an important part in timely referral, in some cases initiating oral antiviral treatment, and by educating patients on preventive measures, especially contact lens hygiene.
患者常因角膜溃疡（定义为角膜上皮和其下基质的缺损）而向全科医生（GP）就诊，表现为眼部不适和眼红。多种疾病均可导致角膜溃疡，为防止视力受损，需要及时诊断和充分治疗。
本文旨在帮助临床医生/全科医生：1）确定角膜溃疡的可能病因；2）了解角膜溃疡的处理方法，包括何时转至眼科医生就诊。
角膜溃疡通常疼痛且会降低视力。充分了解角膜溃疡的临床表现有助于诊断和指导治疗。对于创伤和感染性角膜炎，应紧急转至眼科医生处，以防止眼内炎和视力丧失和/或眼球丧失。全科医生在及时转诊方面可发挥重要作用，在某些情况下可开始口服抗病毒治疗，并通过教育患者预防措施，尤其是隐形眼镜卫生，来发挥作用。
