Recurrent Erosion Syndrome (RES) is a spontaneous breakdown of the corneal epithelium (the outermost layer of the cornea). This occurs because the outer layer is weakly attached to the underlying membrane. The most common cause of Recurrent Erosion Syndrome is an initial minor corneal injury or abrasion, such as that caused by a fingernail. Other disease processes that can elicit Recurrent Erosion Syndrome include dystrophies, infections, diabetes, and dry eyes.. ...
This study investigated DE-105 in patients with persistent corneal epithelial defect. The primary endpoint was restoration of corneal epithelial defect assessed
This study also suggests that α-toxin is active in producing ocular changes in eyes infected with strain Newman. All the Newman strains, except the one deficient in α-toxin, produced corneal epithelial erosions that were readily visible on gross examination and in histologic sections of corneas. Corneal erosions produced by the γ-toxin-deficient Newman strain, but not the α-toxin-deficient mutant, are evidence for a role for α-toxin in corneal epithelial erosion produced by strain Newman. Also, supporting a role for α-toxin in the corneal virulence of strain Newman was the protection against corneal damage, especially epithelial erosion, afforded by either active or passive immunization to α-toxin. The epithelial erosions caused by Newman strains developed more slowly and were smaller throughout the 25 hours of infection than those caused by strain 8325-4, a strain in which α-toxin is the key hemolytic toxin. This difference in the rate of erosion formation correlates with the relatively ...
Terri L. Young, M.D., M.B.A. is a board-certified clinician-scientist ophthalmologist. She is a Professor of Ophthalmology, Pediatrics, and Medicine at Duke University School of Medicine. She is a Professor of Neuroscience at the Duke- National University of Singapore Graduate Medical School, with adjunct appointments at the Singapore Eye Research Institute and the Saw Swee Hock School of Public Health, National University of Singapore. She is the founding Director of the Duke ...
Recurrent corneal erosions are a common complication of superficial corneal wounds. They most commonly arise following a trauma, in association with various corneal dystrophies, or are idiopathic.. The main aim of this thesis was to investigate two hereditary corneal diseases with recurrent erosions in order to find out if they had been described before, and more specifically to describe the clinical picture and the morphological changes, differentiate them from other known autosomal dominant corneal dystrophies with a clinical resemblance, and to exclude genetic linkage to known corneal dystrophies with autosomal-dominant inheritance and a clinical resemblance.. The thesis is based on two families of subjects belonging to different phenotypes. The subjects from Småland (Dystrophia Smolandiensis) belonged to a six-generation family, which included 171 individuals of whom 44 were affected individuals, and the family from Hälsingland (Dystrophia Helsinglandica) included sevengenerations of 342 ...
Results Overall, 12 113 of 12 899 people (93.9% response rate) were examined during the household visits. Prevalence of corneal disease was 3.7% (95% CI 3.4% to 4.1%) and that of corneal blindness was 0.12% (95% CI 0.05% to 0.17%). Multivariable analysis demonstrated that corneal disease was significantly higher in the elderly (p,0.0001) and illiterates (p,0.0001). Common causes of corneal opacity in the study population were pterygium (34.5%), ocular trauma (22.3%) and infectious keratitis (14.9%). Corneal diseases contributing to blindness were post-surgical bullous keratopathy (46.2%) and corneal degenerations (23.1%).. ...
There are several reports on the treatment of recalcitrant recurrent corneal erosion syndrome by excimer laser PTK.23-31 The reported rate of success, regarding alleviation of symptoms and prevention of recurrence of epithelial erosion, ranges between 74.4% and 100%.23-31 Dauschet al 23 reported a success rate of 74.4% in 74 eyes treated by PTK. OBrart et al 27reported that four out of 17 eyes (23.5%) experienced recurrent episodes 3-6 months after PTK and two have subsequently been retreated, one of whom has been symptom free for 12 months following retreatment. Postoperative BVA was unaltered in nine eyes and improved by at least one Snellen line in eight eyes. Both Forster et al 31 and Algawi et al 24 reported that none of their treated patients had experienced recurrence of corneal erosion. However, Algawi et al24 reported that two of 14 patients still complained of transient, recurrent foreign body sensation following PTK, although none of their patients developed recurrence of the ...
Enjoy this 7-page print monograph focused on the importance of and best practices for diagnosis and management of important corneal disorders in the cataract and refractive surgery patient ...
Role of bandage contact lens in corneal disorders: A review-IJOOO-Print ISSN No:-2581-5024 Online ISSN No:-2581-5016Article DOI No:-10.18231/j.ijooo.2019.060,IP International Journal of Ocular Oncology and Oculoplasty-IP Innovative Publication Pvt Limited, Medical Journals Publication, Open Access Journals, Print Jou
CORNEAL ABRASION Corneal abrasions, a cut or scratch of the clear window of the eye, are associated with light sensitivity, pain, and tearing. Corneal abrasions may cause mild discomfort or severe pain, depending on the size of the abrasion. Treatment may include lubrication, bandage contact lens, eye patching and/or preventative antibiotic ointment. The cornea is the fastest healing tissue in the human body, thus, most corneal abrasions will heal within 24-36 hours.. BAND KERATOPATHY Band keratopathy is a calcium deposit at the 3-9 oclock positions in the front layer of the cornea. This deposit of calcium may spread across the cornea in band like appearance. The condition is caused by inflammations, trauma, chronic ocular disease, or even systemic diseases.. Treatment is necessary when the deposits affect vision. If the band of calcium deposits affect visions, chemical removal can be considered. Usually, vision improves following the removal of calcium from the cornea.. CORNEAL DELLEN Dellen ...
Presents high-magnification in vivo images of the morphology of recurrent corneal erosions and epithelial edema as captured by non-contact
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The treatment for recurrent corneal erosion is very similar to that for corneal abrasion. Patching is often very helpful, usually after the instillation of an antibiotic ointment. The doctor may teach you how to open your eye carefully and remind you never to rub the eye. If there is an underlying corneal disease requiring treatment, that too will be addressed. Often, you will be given a salt-like drop for day use and salt-like ointment for nighttime use. The salt pulls fluid out of the corneal epithelium, allowing it to lay down tighter to the underlying basement membrane and, hence, heal better. Map-dot fingerprint dystrophy, which most patients dont know they have, usually resolves over several years on its own without treatment. Some patients may also be taught how to apply a tight patch that restricts eye movement at night and upon waking so there is less likelihood of recurrence. If these rather simple procedures are not successful, the eye care professional may re-scrape the area to ...
Recurrent corneal erosion (RCE) is a repeated breakdown on the surface of the eye causing severe eye pain, light-sensitivity, tearing, and corneal scarring leading to visual changes...
Diagnosis Code H18.832 information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index.
Title:Corneal Changes in Diabetes Mellitus. VOLUME: 8 ISSUE: 4. Author(s):Guzel Bikbova, Toshiyuki Oshitari, Ayako Tawada and Shuichi Yamamoto. Affiliation:Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Chiba, Japan.. Keywords:Advanced glycation end-products, corneal wound healing, diabetes mellitus, endothelial cell dysfunction, epithelial defect, growth factors, neurotrophic keratopathy, vitrectomy, keratopathy, diabetic polyneuropathy. Abstract:Diabetes mellitus is a major disease worldwide, and the prevalence of diabetes has risen significantly in the past several decades. Although one of the major complications of diabetic eyes is diabetic retinopathy (DR), corneal diseases can not only develop in diabetic patients but are also difficult to manage. Diabetic neurotrophic keratopathy is a component of diabetic polyneuropathy and is recognized to be the cause of the morbidity of the cornea in diabetic ...
To date, GWAS in humans have identified 27 CCT-associated loci,13,16,23-25 and QTL analysis in mice has identified 6 CCT-associated loci. Some of the genes identified in GWAS were independently identified as CCT regulators because of their association with rare connective tissue disorders (i.e., brittle cornea syndrome and osteogenesis imperfecta).11,12,15 The genes identified by GWAS show an enrichment of pathways involving collagen and extracellular matrix (ECM), which might be expected since the cornea is composed largely of an ECM-rich stroma. Other CCT-influencing genes (e.g., Twist2, Bnc1, Bcl-2, and Bax) have been identified through studies that used candidate-driven approaches.44-46 A comparison of the syntenic regions of Cctq4 indicated that this locus overlaps partially with Tiparp, a locus previously reported to be associated with CCT in humans based on a meta-analysis by Lu et al.16 However, Tiparp is unlikely to be the gene underlying the association between Cctq4 and CCT because it ...
Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Merck Manual was first published in 1899 as a service to the community. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Learn more about our commitment to Global Medical Knowledge.. ...
Cornerstone Eye Associates provides several effective treatments for corneal diseases in Rochester, NY. Call today to schedule your appointment!
The corneal epithelial cells are the fastest reproducing cells in the human body, but it will take time for them to cover the area, thicken, and smooth. You will undoubtedly have some corneal edema (inflammation) from the insult, which will cause fluctuations in your refractive error and likely an uneven healing pattern until things settle down. Your poor vision will wax and wane and change over the next 2-3 weeks. You will likely not get the really good vision you want until 4-6 weeks or even a bit longer. You will undoubtedly have functional vision within a week, but you wont be threading any needles with that eye ...
Diabetic corneal neuropathy: clinical perspectives Guzel Bikbova,1,2 Toshiyuki Oshitari,1 Takayuki Baba,1 Mukharram Bikbov,2 Shuichi Yamamoto1 1Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan; 2Cornea and Refractive Surgery Department, Ufa Eye Research Institute, Ufa, Russia Abstract: Diabetic keratopathy is characterized by impaired innervation of the cornea that leads to decreased sensitivity, with resultant difficulties with epithelial wound healing. These difficulties in wound healing put patients at risk for ocular complications such as surface irregularities, corneal infections, and stromal opacification. Pathological changes in corneal innervations in diabetic patients are an important early indicator of diabetic neuropathy. The decrease in corneal sensitivity is strongly correlated with the duration of diabetes as well as the severity of the neuropathy. This review presents recent findings in assessing the ocular surface as well as the
I took my defect a little longer to heal, (I dont know if it was because the flap was lifted before it healed) ,it healed rapidly and then slowed. But it closed Yesterday, and that was my worse vision day thus far. It was so so blurry it made my head swim. However I still have some DLK inflammation that has persisted around the edge of my flap and he has increased my steroid drops and oral steroids a little. But other that that my vision isnt as bad today. But it is still a blurry mess overall ...
Purpose. To report a case of a patient with rheumatoid arthritis (RA) treated with tofacitinib citrate. Methods. Observational case report. Results. A 59-year-old patient, with a history of rheumatoid arthritis, on methotrexate 10 mg PO qwk and IV abatacept 750 mg/month, presented with photosensitivity, foreign body sensation, pain, redness, and blurry vision of her right eye (RE). Visual acuity of the RE was 20/200 and 20/20 of the left eye (LE). The slit lamp examination of the RE revealed dryness, 2+ injection of the conjunctiva, and pericentral ulceration of the cornea with 20-30% stromal thinning, pannus, and diffuse punctate epithelial erosions ...
Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Merck Manual was first published in 1899 as a service to the community. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Learn more about our commitment to Global Medical Knowledge.. ...
This is lipid deposition with associated blood vessels probably after a corneal ulcer. Wed call this a lipid keratopathy, though Ive never seen one in a cat before and cant find a report of it in the literature. Not enough money, or a calm enough cat, to take a blood sample for lipid analysis Im afraid, but as the cat is happy no treatment is needed. If it were maybe the driver of this truck I passed on the way home from the consultation would be able to help! ...
read Ocular Diagnostic Preparations for- tear film assessment, identification of corneal epithelial defects/corneal disease and more about Ocular Diagnostic Preparations
Find information on Band Shaped Keratopathy : Introduction, Symptoms, Causes, Diagnosis, Management , Prevention - www.genericdrugscan.com
Your cornea - the clear, protective outer layer of the eye - not only protects your eye from dirt and germs, but also plays a key role in your vision. As light
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Etiology: Band keratopathy derives its name from the distinctive appearance of calcium deposition in a band across the central cornea. Band keratopathy can occur from a variety of causes, both systemic and local. Bank keratopathy is associated with chronic corneal edema (perhaps the most common treatable cause accounting for over 1/4 of cases in one series), phthisis bulbi, chronic iridocyclitis, severe glaucoma, hyperparathyroidism, vitamin D excess, sarcoidosis or renal disease. The latter 4 are related to abnormal calcium metabolism. Severe dry eye may also precede band keratopathy. Herpes keratitis may predispose to band keratopathy. The use of phosphate salts in steroid preparations may precipitate calcium in patients with epithelial defects ...
Case Report DOI:10.14744/bej.2019.79553 Beyoglu Eye J 2019; 4(2): 126-129 Manual Intracorneal Silicone Oil Insertion for Symptomatic Treatment of Bullous Keratopathy in a Patient with Corneal Scarring Selim Genc, Semih Cakmak, Yusuf Yildirim Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey Abstract Bullous keratopathy is a result of endothelial loss and the failure of the remaining corneal epithelium to pump leaking water molecules away from the corneal tissue, causing overhydration. In eyes with good visual potential, keratoplasty is the primary treatment. There are also several other approaches to provide temporary improvement until a permanent solution with keratoplasty can be achieved. These alternatives include hypertonic topical sodium chloride (5%) drops, bandage contact lenses, anterior stromal puncture, phototherapeutic keratectomy, amniotic membrane transplantation, conjunctival flaps, and collagen crosslinking. ...
PURPOSE: We report our experience with the use of maternally derived serum eye drops as adjunctive treatment in the management of pediatric persistent corneal epithelial defects. METHODS: Five eyes of 4 patients were identified in a retrospective review of pediatric patients with persistent corneal epithelial defects who received maternal serum drops. Diagnoses associated with the defects comprised pontine tegmental cap dysplasia with bilateral cranial nerve V1, V2, V3, and VII palsies; pontine tegmental cap dysplasia with left cranial nerve V1, VII, and VIII palsies; traumatic left cranial nerve II, V1, V2, and VI palsies due to a basilar skull fracture; and Stevens-Johnson syndrome with ocular involvement ...
Abstract Objective: A population of stem cells (SCs) is responsible for maintenance and repair of the ocular surface. These stem cells can become deficient as a result of various diseases affecting the ocular surface. Depending on the extent of damage, the clinical features can vary from mild discomfort to substantial pain and/or blindness. The growing field of tissue engineering and advances in stem cell research offer promising new alternatives for these disorders. This student thesis will provide an overview of the human ocular surface (cornea, limbus, and conjunctiva), ocular surface stem cell deficiency, and treatment possibilities. Methods: This student thesis is based on a number of review articles and original articles on PubMed using the search words limbal, limbal stem cell deficiency, conjunctival and/or ocular surface reconstruction. Only papers written in English were considered. Findings: There are different possible methods for treating ocular surface stem cell deficiency by ...
Aniridia is a congenital autosomal dominant, bilateral, panocular condition, caused by haploinsufficiency of the Pax6 transcription factor. Aniridia-related keratopathy (ARK) significantly affects vision and quality of life in these patients. ARK is a chronic progressive keratopathy comprising limbal stem cell deficiency associated with impaired epithelial cell adhesion, corneal conjunctivalization, epithelial erosions and corneal vascular pannus that typically only appear after childhood.. The aims were i) to evaluate the structural changes and ii) cell signaling pathways, including the Notch1, Sonic Hedgehog (SHH), mTOR and Wnt/beta-catenin cell signaling pathways in naïve and surgically treated corneas of aniridia cases with advanced ARK and comparing with normal human adult and fetal corneas and iii) to develop a corneal cell culture model of aniridia.. Naïve ARK corneas removed at the time of the first transplantation and ARK corneal buttons removed after a failed keratolimbal allograft ...
Corneal transplant surgery is the most commonly performed of all transplant operations, with approximately 45,000 corneal transplant procedures being performed in the Unites States each year. The indications for corneal transplant surgery have changed through the years. Pseudophakic bullous keratopathy and aphakic bullous keratopathy (corneal edema secondary to cataract surgery) accounted for 80% of corneal transplants in the 1980s. However, with the improvement of cataract surgery techniques, conditions such as Fuchs Dystrophy, Keratoconus, and other corneal dystrophies are now more commonly transplanted.. In 1933, corneal transplants were performed using two razor blades to make a square graft. Patients were hospitalized for two weeks with sand bags on either side of their head to prevent undesirable movement and possible leakage from the wound sites. Since then, there have been major advances in surgical technique including the introduction of the operating microscope (1970s) and better ...
The Table summarizes the patients demographics, ocular comorbidity, concomitant treatment, and clinical manifestations including symptoms and signs at the presentation. Conjunctival inflammation was graded according to the conjunctival injection as none (0), mild (1), moderate (2), and severe (3). The corneal surface integrity was scored as clear (0), scattered superficial punctuate keratitis (SPK; 1+), moderate SPK (2+), and diffuse SPK with or without corneal epithelial defects (3+). The tear function was assessed by the fluorescein clearance test as reported28 using the Schirmer paper strip following topical application of 5 μL of Fluroress (Akorn Inc., Abita Springs, LA). The diagnosis of dry eye disease (DED) was based on the wetting length of less than 3 mm at the 10th and 20th minute. For Case #2 who presented with epithelial basement membrane dystrophy (EBMD), the diagnosis was confirmed by observing corneal epithelial wrinkles or breaks by the "screwdriver test," which applies a dry ...
A limbal biopsy taken from the contralateral good eye in cases of unilateral disease or from a living related or cadaveric donor in cases of bilateral disease. The limbal stem cells from the biopsy are cultivated until a sheet of cells measuring approximately 12mm in diameter is obtained. This is then ready for transplantation onto the diseased eye ...
Looking for online definition of corneal erosion syndrome in the Medical Dictionary? corneal erosion syndrome explanation free. What is corneal erosion syndrome? Meaning of corneal erosion syndrome medical term. What does corneal erosion syndrome mean?
The results from this research may open the door to future therapeutics for a myriad of corneal disorders. "It is essential to know the biochemical composition of normal healthy corneas in the effort to understand the molecular mechanisms behind corneal disorders," emphasizes Dr. Enghild. "By comparative proteomic studies of diseased and normal corneas we can identify differences in the expression profiles that may suggest avenues for therapeutic interventions. Because the cornea is so accessible, the potential for developing effective drugs for the treatment of corneal diseases is good. Furthermore, the work is likely to improve the clinical classifications of corneal diseases. Identification of the protein profile of the normal human cornea may also be very useful in the effort toward generating artificial corneas for transplantation ...
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Article in Press, EJCTS-6393; No of Pages 5 David Crane et al, Platelet Rich Plasma Matrix Grafts, Prctical Pain Management, Jan/Feb 2008 Lopez-Plandolit S, Morales MC, Freire V, Etxebarria J, Duran JA. Plasma rich in growth factors as a therapeutic agent for persistent corneal epithelial defects. Cornea. 2010 Aug;29(8):843-8.. Allio, Jorge L., Colecha, Jose R., Pastor, Silvia, Rodriguez, Alejandra, and Artola, Alberto. Symptomatic Dry Eye Treatment with Autologous Platelet-Rich Plasma. Opthalmic Res 2007;39:124-129.. Orthopedic - General. Muschler, G, et al, Age - and Gender - Related Changes in the Cellularity of Human Bone Marrow and the Prevalence of Osteoblastic Progenitors, Journal of Orthopaedic Research, 2001: 19;117-125. Romih, M, et al, The Vertebral Interbody Grafting Sites Low Concentration in Osteogenic Progenitors can Greatly Benefit from Addition of Illiac Crest Bone Marrow, European Spine Journal, 2005: 14;645-648.. Bodke, D, et al, Bone Grafts Prepared with Selective Cell ...
2. A Ocular surface reconstruction with allolimbal transplantation and use of two membranes. The inner 9-mm disc acts as a graft and the outer larger membrane as a patch. S. Dua). B The outer membrane has cut through sutures and retracted, exposing the inner membrane. e. 5 Clinical Studies and Outcomes (Definitions of Success and Grading of Disease Severity) A B membrane was intended as a patch and acted as such for the expected duration but the PED did not heal. When the above criteria were applied to 74 procedures involving use of the amniotic membrane, failure of the procedure was observed in 44 % of patients where the membrane was used in the presence of stem cell deficiency, in 33 % of procedures where the membrane was used in the absence of stem cell deficiency and in 44 % of patients where the membrane was used for conjunctival reconstruction. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. References 1. Anderson DF, Ellies P, Pires RT, Tseng SC (2001) Amniotic membrane transplantation for partial ...
Additional file 1: of Transplantation of oral mucosal epithelial cells seeded on decellularized and lyophilized amniotic membrane for the regeneration of injured endometrium
There are currently no human or mouse genes associated with this disease in the MGI database. Synonyms: Band-shaped keratopathy
The National Institute of Health has a webpage (https://nei.nih.gov/health/cornealdisease) which reviews the structure of the eyes outermost front layer, the cornea, and various diseases that can affect it. These common diseases include Corneal Infections, Dry Eye, Fuchs Dystrophy, Herpes Zoster (Shingles), Iridocorneal Endothelial Syndrome, Keratoconus, Lattice Dystrophy, Map-Dot-Fingerprint Dystrophy, Ocular Herpes, Pterygium, and Stevens-Johnson Syndrome. ...
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patients clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician ...
TY - JOUR. T1 - Clinical application of living-related conjunctival-limbal allograft. AU - Tsubota, Kazuo. AU - Shimmura, Shigeto. AU - Shinozaki, Naoshi. AU - Holland, Edward J.. AU - Shimazaki, Jun. PY - 2002. Y1 - 2002. N2 - PURPOSE: To report one successful case of conjunctival-limbal allograft for the treatment of a severe ocular surface disorder. METHODS: Interventional case report. A 9-year-old patient suffering from Stevens-Johnson syndrome with total keratinization of the ocular surface of both eyes was treated in the left eye by corneal and conjunctival stem cell transplantation. Oral cyclosporin A and topical autologous serum and corticosteroids were administered. RESULTS: Mucosal epithelial phenotype was maintained in the left eye at most recent examination for more than 3 years after ocular surface reconstruction. CONCLUSION: A total keratinized ocular surface may be treated with the combination of conjunctival and corneal stem cell transplantation.. AB - PURPOSE: To report one ...
The gel is a means of stimulating wound healing.. Treatment of noninflammatory diseases of the cornea of ​​the eye (keratopathy), z. Dystrophies of the cornea (eating disorders), degeneration of the cornea (regression), recurrent corneal erosion (Abschilferungen) and corneal injury (injury) in contact lens wearers.. An additional medicine to support the healing of damage to the cornea and conjunctiva, corrosion and burns.. An additional medicine for specific therapy of infectious corneal processes of bacterial, viral or mycogenous (caused by fungi) origin.. Note:. The gel is not suitable for the treatment of infectious corneal processes of bacterial, viral or mycotic origin, but only as an additional medicine for the specific therapy of these corneal diseases.. ...
Anesthetic keratopathy presenting as bilateral Mooren-like ulcers Hamid Khakshoor,1 Majid Moshirfar,2 Rachel G Simpson,3 Hamid Gharaee,1 Amir H Vejdani,1 Steven M Christiansen,2 Jason N Edmonds,2 Nicholas L Behunin21Mashhad University of Medical Sciences, Department of Ophthalmology, Mashad, Iran; 2John A Moran Eye Center, University of Utah, Salt Lake City, UT, 3The University of Arizona College of Medicine, Phoenix, AZ, USAAbstract: This observational case report describes the development of bilateral Mooren-like ulcers in a patient with anesthetic keratopathy. A 42-year-old man with a recent history of minor eye trauma and pain self-treated with tetracaine eye drops presented with complaints of acutely worsening vision and severe pain bilaterally. His visual acuity at presentation was limited to hand motion. Slit-lamp examination revealed bilateral epithelial defects at the center of the cornea, and an area of stromal infiltration and thinning with an undermining leading edge resembling a Mooren'