Steroid is contraindicated in ?
Ans. is 'c' i.e., Fungal corneal ulcer Topical coicosteroids enhance fungal replication and corneal invasion and therefore, contraindicated in a fungal corneal ulcer. Now, option 'a' requires specific mention here :- Topical coicosteroids are contraindicated in herpetic keratitis. But not in all forms of herpetic keratitis :- Epithelial herpetic keratitis (Dendritic ulcer, geographic ulcer) Topicla coicosteroids are contraindicated. Stromal keratitis (Disciform & Diffuse necrotic) Topical coicosteroids along with topical antiviral drugs are used as the first line of treatment. So, my opinion for this type of question is that :- If herpetic keratitis has given as the option, then look at other options. If any of the other options is a clear cut contraindication for coicosteroid (e.g. fungal corneal ulcer in this question), consider that option as your answer. If no ther option is a contraindication for topical coicosteroid, considere herpetic keratitis as the answer. If examiner has specifically mentioned dendritic ulcer as an option, consider it as the answer.
Herpetic keratitis
Atopic dermatitis
Fungal corneal ulcer
Exposure keratitis