The characteristic features are sharp pain, often described as a foreign body in the eye, marked watering of the eye, photophobia and difficulty in opening the affected eye. The clinical picture is different from those of the above two conditions and the commonest causes are the herpes simplex virus or trauma. The possibility of a perforating injury must always be borne in mind. Sometimes children are reticent about any history of injury for fear of incriminating a friend, and sometimes a small perforating injury is surprisingly painless. The treatment of acute keratitis has already been discussed in Chapter 6 and the management of corneal injuries will be considered in Chapter 16.
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