An epithelial defect that is significantly smaller than the underlying infiltrate is more indicative of which type of ulcer?

• A. Infectious Ulcer
• B. Nonulcer Keratitis
• C. Undetermined Etiology
• D. Sterile Ulcer

Answer: (D)

The main idea is that the relationship between the epithelial defect and the stromal infiltrate helps distinguish infectious from sterile inflammation in the cornea. When the epithelial defect is much smaller than the underlying infiltrate, it suggests the inflammation is primarily in the stroma and the epithelium is relatively spared. That pattern points to a sterile ulcer (noninfectious inflammatory process). In infectious keratitis, you’d expect the epithelial breakdown to be more extensive and often align with or exceed the size of the infiltrate due to direct tissue damage from pathogens. So the described finding best fits a sterile ulcer.