Internal Medicine

0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54

Contraception for the Internist Corneal Ulcer 403

■Contraindications

➣Risk of surgery outweighs benefit of sterilization

■Complications

➣Pregnancies occurring after sterilization usually are ectopic

➣Poststerilization regret

■Prognosis

➣10-year cumulative failure rate:

Postpartum, 0.8%

Unipolar coagulation, 0.8%

Bipolar coagulation, 2.5%

Spring clip, 3.7%

Falope ring, 2%

Filshie clip, 0.7% 2-y cumulative failure rate

Vasectomy, 0.15% 1-y failure rate

follow-up

n/a

complications and prognosis

n/a

Corneal Ulcer.......................................

DOUGLAS S. HOLSCLAW, MD

history & physical

History

■Contact lens wear, trauma, ocular foreign body, dry eyes, trichiasis,

lagophthalmous, neurotropic cornea, topical steroid use, history of

atopy or ocular herpes simplex

Signs & Symptoms

■Redness, mild to severe ocular pain, photophobia, blurry vision, ocu-

lar discharge

■Critical signs: focal white opacity (infiltrate) cornea stroma, overlying

epithelial defect w/ fluorescein staining

■Other signs: eyelid edema, conjunctival injection, ciliary flush,

corneal stroma edema, Descemet folds, anterior chamber cells &

flare, hypopion

■Severity of symptoms depends on causative organism