40. PHLYCTENULOSIS
• Predominantly affects children
• Etiology – Tuberculosis
– Delayed hypersensitivity reaction to staphylococcal or other
bacterial antigen
42. • A phlyctenule (also called phlycten) is a characteristic nodular
affection occurring as an allergic response of the conjunctival and
corneal epithelium to some endogenous allergens to which they have
become sensitized.
44. SIGNS
• Conjunctival: Pinkish-white nodule surrounded by hyperaemia
• Corneal: May resolve spontaneously or extend radially to the cornea.
May cause severe ulceration or perforation.
48. Causes:
• Tuberculous protein
• Staphylococcus protein-most common
• Others- Moraxella axenfeld bacillus and certain parasites
49. • Predisposing factors:
• Age—3-15 yrs
• Under nourished
• Living conditions- over crowded and unhygienic conditions
• Season- more in spring and summer
52. • Treatment:
• local-
• -topical steroid-dexamethasone or betamethasone
• -antibiotic drops and ointment
• -atropine 1% eye ointment once daily if cornea is involved
• specific:
Tuberculosis should be excluded by Chest x-ray, mantoux test, ESR and if necessary full dose ATT
should be given.
• -Septic focus in the form of tonsillitis, adenoiditis, teeth caries should be treated by antibiotics
and necessary surgical interventions.
• -parasitic infestation should be ruled out and treated if necessary.
• General:
high protein diet and Vit. A, C, and D supplementation.