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Ophthalmology · Cornea: disciform keratitis
Sample itemA patient with prior herpetic keratitis has a central disc-shaped stromal oedema with keratic precipitates and an intact epithelium. What is the mainstay of treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Topical steroids with antiviral cover
Disciform keratitis is an immune endotheliitis and stromal reaction to herpes antigens. Topical steroids reduce inflammation and are given under antiviral cover.
Option by option
A. Antifungal drops
There is no fungal element.
B. Debridement of the epithelium
Debridement is used in dendritic ulcers, not disciform disease.
C. Topical steroids with antiviral cover (correct)
Correct. Steroids with antiviral prophylaxis are standard.
D. Topical antiviral alone, avoiding steroids
Antiviral alone is insufficient for the immune-mediated process.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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