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Staph marginal keratitis (Video)

length: 23 seconds

This video shows a sterile corneal infiltrate at the inferior limbus in an eye with blepharitis. This opacity is entirely sterile and occurs from a hypersensitivity reaction at the limbal vessels in the cornea. This eye was treated successfully with good lid hygeine and a mild steroid.

This entity is usually bilateral, and as you can see there is a clear zone at the edge of the limbus that isn’t affected.

Download this video for powerpoint

download.gifTo download this video, right click on a link below and choose “Save Target As…”

but.gifstaphmarginal.wmv (3.3 meg, Windows video file)
but.gifstaphmarginal.mov (Quicktime format coming soon)


Thumbnails (click to enlarge photo)

staphmarginalcornea.jpg staphmarginal.jpg


good presentation

Comment by komalta — March 10, 2010

Why use a steroid for a bacterial-based pathology?

Comment by Nick — December 18, 2011


I use steroids as staph marginal is more of an inflammatory reaction to bacteria along the eyelids than an infiltrative lesion. Thus, treatment is geared at decreasing the bacterial load (lid scrubs, antibiotic drops) AND decreasing the inflammatory response (steroids).

Your gut reaction is a good one … as normally, steroids aren’t a good idea in the face of infection. I tend to watch larger lesions (like the one in this video) closely in case it turns into a full-blown ulcer. If so, then I stop the steroid, culture, and ramp up the antibiotic coverage.

Comment by admin — December 18, 2011

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