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What is A patient wakes up at 3 AM with acute pain. O/E 7 hours later the eye appears quiet, with mild corneal stippling and irregularity. What is the most probable diagnosis? and explain in detail?
Recurrent corneal erosions (recurrent keratalgia). These may sometimes follow simple abrasions, especially those caused by finger nail trauma. Patient usually gets recurrent attacks of acute pain and lacrimation on opening the eye in the morning. This occurs due to abnormally loose attachment of epithelium to the underlying Bowman's membrane. Treatment. Loosely attached epithelium should be removed by debridement and 'pad and bandage' applied for 48 hours, so that firm healing is established. Angle closure glaucoma doesn't cause pain at night since during sleep the pupils are constricted.