Inflammation and ulceration of the cornea can be caused by trauma, surgery to the eye, infectious diseases and systemic diseases. The trauma can be mechanical, chemical or caused by heat or irradiation. The increasing incidence of cataract extraction has led to an increase in cases with corneal damage during the surgical procedure. Infectious keratitis can be viral, bacterial, fungal or parasitic. In chronic granulomatous keratitis, causes like leprosy, syphilis and tuberculosis should be considered. Especially in immunocompromised patients infectious causes should be excluded by additional stains like PAS, Grocott and Gram. In corneal ulcers without a clear aetiology, artificial keratitis has to be considered. Factitious injury is rare and can be either the result of mechanical trauma or the abuse of toxic eye drops [26]. Histology of factitious lesions is non-specific. An example of a systemic disease affecting the cornea is muco-polysaccharidosis (Fig. 10.16).

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