marginal keratitis

mar·gi·nal ker·a·ti·tis

a corneal inflammation at the limbus.

marginal keratitis

An eye disease characterised by a toxic or hypersensitivity response to bacterial (Staphylococcal) exotoxins.

Predisposing factors
Bacterial/staphylococcal blepharitis, recurrent upper respiratory tract infection.
 
Clinical findings
Ocular pain, lacrimation, red eye, photophobia; ulcer (stromal infiltrate with overlying epithelial loss) that may be round or arcuate, single or multiple, unilateral or bilateral, adjacent to limbus, and separated from limbus by interval of clear cornea; ulcer stains with fluorescein; hyperaemia and oedema of adjacent bulbar conjunctiva.

DiffDx
Contact-lens-associated microbial keratitis, contact-lens-associated corneal infiltrate, rosacea keratitis, Mooren’s ulcer, peripheral keratitis associated with rheumatoid arthritis or other systemic collagen vascular disease, corneal phlyctenulosis, Terrien’s marginal degeneration.
References in periodicals archive ?
Marginal furrow degeneration, Dellen, collagen vascular diseases, sclerokeratitis, staphylococcal marginal keratitis, pellucid marginal degeneration etc have been proposed as differential diagnosis.
of episodes Amaurosis fugax 1 Angle closure glaucoma 1 Anterior uveitis/iritis 1 Corneal abrasion 1 Corneal ulcer 1 Herpes keratitis 3 Malignant BCC/SCC/SGC 1 Marginal keratitis 2 Septal cellulitis/peri-orbital 3 Retinal tear/hole 5 Scleritis 3 Viral conjunctivitis 1 Wet AMD 1 Figure 1 Appropriateness of optometrist referral (was the referral appropriate based on outcome of assessment?
In the case of marginal keratitis, this is always treated more conservatively with polyfax qid; steroids are not considered necessary in all cases.
Long-term and/or extended wear of contact lenses may result in marginal keratitis, which is a mild-to-moderate inflammatory response that is often refractory to management.
Marginal keratitis in the absence of contact lens wear
As noted earlier, non-infectious inflammatory conditions such as VKC can be associated with marginal keratitis and can even progress to substantial corneal epithelial problems such as non-infectious (shield) ulceration.
An infectious blepharitis, if not managed properly, can easily lead to development of blepharoconjunctivitis whereby the bacteria infect the mucous membranes of the conjunctiva as well as the eyelid margins, and can also be associated with a marginal keratitis (see next article in this series).