Keratopathies:

Various Corneal Changes And Their Treatments Part 1

Corneal Vascularisation: vascular keratitis, pannus, dry eye, healed ulcer
1. Perform a STT to rule out/in dry eye.
2. Perform fluorescein dye.
3. If STT normal and dye negative: topical cortisone drops.
4. Prednefrin Forte or Maxidex drops TWICE daily until blood vessels resolved/greatly reduced then ONCE daily. Long term treatment may be needed. May recur even months later if stop the treatment.
5. Client education: stop the drops if the eye is sore (closed, rubbing, watery, mucky, blue or red in a different way) and contact you ASAP.
6. Continue to monitor STT throughout treatment as an irritated eye will have an increased reflex component to their tear reading.

Corneal Pigmentation: dry eye, pannus, pigmentary keratitis (e.g. Pug)
1. Perform a STT and fluorescein dye.
2. If surface is irregular, flush the cornea e.g. with tears as dye will sit in hollows.
3. Tacrolimus 0.02% drops twice daily. Best used in conjunction with topical cortisone e.g. Maxidex drop, wait 30 mins then Tacrolimus twice daily.
4. Tacrolimus is expensive to make up so referral is suggested.
5. Corneal pigment can take a few months to improve. Long term treatment is often required to keep the pigment controlled.