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Improving corneal melt treatment: A practical approach

Healio Optometry5h ago1 min read

Far more than a superficial epithelial problem, corneal melt is a progressive ulceration of corneal stromal tissue that can compromise the structural integrity of the eye.Corneal melt often precedes perforation, when the melt progresses through the full thickness of the cornea and leaves the eye an open globe, a significant cause of blindness that necessitates urgent intervention (Hossain).Causes of corneal melt include infections, autoimmune diseases, trauma, medications and severe dry eye. The two primary causes are infections or autoimmune diseases; infections are by far the largest

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AI Summary

Quick Take

Corneal melt is a progressive ulceration of the corneal stroma that poses a severe threat to the eye's structural integrity. While it can be triggered by trauma or medications, infections and autoimmune diseases are the primary drivers, frequently leading to full-thickness perforation and permanent blindness if not treated urgently.

Why It Matters

Distinguishing a corneal melt from a standard epithelial defect is a critical clinical distinction because the window for saving the globe is often very narrow. Because infections are the most common cause, rapid antimicrobial intervention is usually the first line of defense, but the presence of autoimmune triggers means clinicians must look beyond the eye to manage the underlying systemic health. Failure to halt the progression of stromal liquefaction can result in an open globe, which remains a significant and preventable cause of vision loss.

Key Findings

Corneal melt is characterized by the progressive ulceration of stromal tissue, rather than just the superficial epithelium.
The condition is a direct precursor to corneal perforation, which creates an open globe and necessitates emergency intervention.
Infections are the single largest cause of corneal melt cases.
Autoimmune diseases are the second most common primary cause of stromal ulceration.
Other contributing factors include ocular trauma, specific medications, and severe dry eye disease.

Practice Implications

Clinicians should treat any sign of stromal thinning as an ocular emergency due to the high risk of perforation. Immediate diagnostic efforts should focus on identifying infectious versus autoimmune etiologies to guide urgent therapeutic intervention and preserve the structural integrity of the globe.

Who's Affected

OphthalmologistsCornea SpecialistsOptometristsEmergency Department Physicians

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