Differentiation of bacterial corneal ulcers from fungal corneal ulcers
Zhang Yu, Ophthalmology Department, Yongchuan Hospital, Chongqing Medical University
Bacterial corneal ulcer
Fungal corneal ulcer
Ulcer formation
Ulcers are often round with uniform infiltration density. Infiltration is denser in the central area of the ulcer
Most ulcers are irregularly shaped with variable density of infiltration
Ulcer surface
The surface is smooth and moist, curved and shiny. Necrotic tissue is sticky and not easy to scrape off
Surface rough, uniformly elevated, poor luster, dry feeling There is “moss scale” or “toothpaste”-like necrotic tissue, non-adhesive, easy to scrape off
Nature of ulcers
soft” gray or gray-yellow ulcer, surrounding corneal stroma cloudy with edema as the main feature, infiltration second, corneal thickening obvious
The ulcer is “hard”, white, yellowish white or grayish white. The stromal clouding is predominantly infiltrative and secondary to edema. Corneal thickening is not evident
Ulcer margins
The ulcer margin is neat, with blurred, cloudy demarcation from the healthy area of the cornea. Ulcer progresses outward from the edge
The edge of the ulcer is irregular and clearly demarcated from the healthy area of the cornea. The ulcer may be enlarged with isolated nodular infiltrating points or protruding tree-root-like stromal infiltrating branches first