Question

A 39 year old female patient comes to the clinic with complains of right eye pain and blurred vision. The patient states that her eye is watering and feels uncomfortable. She does not wear contact lenses. The nurse practitioner uses fluorescein dye strips with Wood's lamp and notes fern-like lines in the corneal surface. The most likely diagnosis would be:

a. Corneal abrasion
b. Foreign body
c. Mydriasis
d. Herpes keratitis

Answer 1

The most likely diagnosis for the patient with right eye pain, blurred vision, watering eye, discomfort, and fern-like lines on the corneal surface is herpes keratitis, an infection that requires treatment with antiviral medications.

Step-by-step explanation:

The patient in the scenario is most likely suffering from herpes keratitis, an infection of the eye caused by the herpes simplex virus (HSV-1). The presence of fern-like lines on the corneal surface after the use of fluorescein dye under a Wood's lamp is indicative of dendritic ulcers, which are characteristic of herpes keratitis. This eye condition can cause pain, blurred vision, excessive tearing, and discomfort, as stated by the patient. Herpes keratitis requires prompt treatment with antiviral medications to alleviate the symptoms and to prevent possible complications, such as corneal scarring and potential blindness.

Signs and Symptoms of Herpes Keratitis

• Irritation and discomfort in the affected eye
• Excessive tearing and blurred vision
• Sensitivity to light
• Fern-like lines on the corneal surface when examined with fluorescein dye