RT Book, Section A1 Al-Maskari, Ahmed A1 Larkin, Daniel F. P. A2 Riordan-Eva, Paul A2 Augsburger, James J. SR Print(0) ID 1144467784 T1 Cornea T2 Vaughan & Asbury's General Ophthalmology, 19e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071843539 LK accessmedicine.mhmedical.com/content.aspx?aid=1144467784 RD 2024/03/29 AB Thorough clinical assessment is crucial in corneal disease as diagnosis is feasible in most cases on the basis of history and clinical examination. A history of trauma or contact lens wear can often be elicited, with foreign bodies and abrasions being the two most common acute corneal abnormalities. Identifying any past or family history of corneal disease can be critical. Herpes simplex infection and corneal erosion are often recurrent, but since recurrent erosion is extremely painful and herpetic keratitis is not, they can be differentiated by the history. Use of topical medications, including nonprescription preparations, should be elicited. Topical corticosteroids predispose to bacterial, fungal, and viral disease, especially herpes simplex keratitis. Many medications and preservatives can cause contact dermatitis or corneal toxicity. Toxicity is an important cause of corneal and conjunctival disease. The keys to examination of the cornea are adequate illumination and magnification, making the slitlamp essential. Examining the reflection as light is moved carefully over the entire cornea identifies rough areas indicative of epithelial defects. Fluorescein staining highlights superficial epithelial lesions that might otherwise not be apparent. Examination, particularly after trauma, is facilitated by instillation of a local anesthetic. Further methods of imaging in corneal disease are listed in Table 6–1.