Steroid is contraindicated in ?
Herpetic keratitis
Atopic dermatitis
Fungal corneal ulcer
Exposure keratitis
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.