Elevated Intraocular Pressure is a Common Complication During Active Microbial Keratitis (original) (raw)
Related papers
Microbial keratitis predisposing factors and morbidity
Ophthalmology, 2006
To examine predisposing factors, treatment costs, and visual outcome of microbial keratitis in an ophthalmic casualty and inpatient population. Retrospective medical records review. Fifteen- to 64-year-olds with microbial keratitis treated at the Royal Victorian Eye and Ear Hospital between May 2001 and April 2003 (n = 291). Risk factors were identified from patient files. Demographic, clinical, and microbiological data; severity; outpatient visits; hospital bed days; and vision loss were examined. Cost to treat (Australian dollars), vision loss, and factors influencing these outcomes. Ocular trauma (106/291 [36.4%]) and contact lens (CL) wear (98/291 [33.7%]) were the most commonly identified predisposing factors; 18 (6.1%) had multiple predisposing factors; 17 (5.8%), ocular surface disease; 20 (6.9%), herpetic eye disease; 4 (1.4%), systemic associations; 5 (1.7%), other; and 23 (7.9%), unknown cause. Of trauma cases, 90.6% involved males, compared with 44% to 57% for other group...
Microbial Keratitis—A Review of Epidemiology, Pathogenesis, Ocular Manifestations, and Management
Nigerian Journal of Ophthalmology
Purpose: To review updated knowledge on the epidemiology, pathogenesis, clinical features, and treatment of microbial keratitis (MK). Source of Data: International and local journals containing current literature on MK were sourced through the Internet. Study Selection: Findings consistent with our objectives were compiled and reviewed. Data Extraction: Data were extracted using endnotes. Results: MK is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. The pathogenesis comprises molecular mechanisms describing microbial activities which involve virulence and host factors responsible for ocular tissue damage and progression in keratitis. Clinical features include redness, pain, tearing, blurred vision, and inflammation, but symptoms vary depending on the causative agent. The primary treatment goal is the elimination of causative organism in addition to neutralization of virulence factors and healing of damaged host tissue. A timely review of our current understanding of MK with the recent advances in its treatment will ensure improved management outcomes. Conclusion: Optimal outcome from management of MK will require an updated knowledge of its pathogenesis, clinical features, and treatment protocols, especially in sub-Saharan Africa where its prevalence is on the increase.
Ophthalmology, 2006
Purpose: To examine predisposing factors, treatment costs, and visual outcome of microbial keratitis in an ophthalmic casualty and inpatient population. Design: Retrospective medical records review. Participants: Fifteen-to 64-year-olds with microbial keratitis treated at the Royal Victorian Eye and Ear Hospital between May 2001 and April 2003 (n ϭ 291). Methods: Risk factors were identified from patient files. Demographic, clinical, and microbiological data; severity; outpatient visits; hospital bed days; and vision loss were examined. Main Outcome Measures: Cost to treat (Australian dollars), vision loss, and factors influencing these outcomes. Results: Ocular trauma (106/291 [36.4%]) and contact lens (CL) wear (98/291 [33.7%])
EPIDEMIOLOGICAL AND MICROBIOLOGICAL PROFILE OF PATIENT'S HAVING MICROBIAL KERATITIS
National Journal of Community Medicine, 2014
Background: Microbial keratitis is common potentially sight threatening ocular infection that may be caused by bacteria, fungi or virus. Epidemiological and microbiological profile of corneal ulceration have been found vary with patient population, health of cornea, geographical location and climate tends to vary over times. Methods: The present cross-sectional study was conducted 3 on patients having microbial keratitis. Detailed history taking include duration of symptoms, predisposing factors, history of trauma, traumatic agents, associated ocular conditions, other systemic disease, treatment received prior to presentation, visual acuity at the time of presentation and all clinical findings were collected. Detailed ocular examination, using standard technique, corneal scraping were also taken under aseptic conditions from each ulcer. Results: In our study, 51 cases belonged to low socio-economic group of which 21 cases (41%) of bacterial keratitis, 15 cases (29%) of fungal keratitis , 11 cases (21%) of viral keratitis and 4 cases (8%) of Mixed (bacterial + fungal ) keratitis. A total 15 bacterial pathogens were isolated from the 64 eyes which yielded only bacterial growth in culture. Out of which 4(16%) were staphylococcus aureus, 4(16%) pseudomonas,3(12%) were streptococcus,2(8%) were staphylococcus epidermis. A total of 17 viral keratitis 9(53%) were recurrent cases. Conclusion: Trauma is most common predisposing factor responsible for microbial keratitis. Direct microscopic examination of corneal scraping is key tool for rapid diagnosing and institution of antimicrobial therapy.
Management of microbial keratitis
2017
Microbial keratitis is the one of the common causes of corneal blindness. It is defined as an epithelial defect with infiltrate. It can be caused by bacteria, virus, fungus, acanthamoeba. Detecting the exact causative organism to ensure prompt treatment is important. In this article we describe the evaluation, management (medical and surgical) of the microbial keratitis. We focus predominantly on bacterial and fungal ulcers in this article.
Bacterial keratitis: perspective on epidemiology, clinico-pathogenesis, diagnosis and treatment
Sultan Qaboos University medical journal, 2009
Bacterial keratitis is an acute or chronic, transient or recurrent infection of the cornea with varying predilection for anatomical and topographical parts of the cornea like marginal or central. It is a potentially sight-threatening corneal infection in humans that is generally found in eyes with predisposing elements, the most common of which is contact lens wear. The epidemiological data reveals the universal occurrence of this disease. With advances in the understanding of its pathogenesis, laboratory investigations like immunohistochemistry, fluorescent microscopy, enzyme immunoassays and molecular biology, and the availability of fourth generation antibiotics, the overall visual outcome in bacterial keratitis has improved with time. Particular attention should be given to this condition as it can progress very rapidly with complete corneal destruction occurring within 24-48 hours. Early diagnosis, which is primarily clinical and substantiated largely by microbiological data, a...
Cornea, 2009
To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). Methods: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. Results: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 6 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (6standard deviation) at presentation: 0.76 (60.11); mean bestcorrected visual acuity at last follow-up: 0.24 (60.07); P , 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxininduced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). Conclusions: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.
Endophthalmitis Associated with Microbial Keratitis
Ophthalmology, 1996
The purpose of the study is to investigate possible risk factors, organisms cultured, and visual acuity outcomes of endophthalmitis associated with microbial keratitis. Methods: Records were reviewed of all patients with both positive corneal and positive intraocular cultures at the Bascom Palmer Eye Institute between January 1, 1990, and March 31, 1995. Results: Thirteen (92.9%) of 14 patients identified had documented keratitis before the diagnosis of endophthalmitis was made. Thirteen (92.9%) patients recently had used 1% prednisolone acetate eye drops, 2 (14.3%) received oral prednisone, and 5 (35.7%) were being treated for systemic conditions associated with relative immune dysfunction. Eight (57.1 %) patients had a history of ocular surgery, and seven (50.0%) had wound abnormalities. Eight (57.1 %) patients lacked an intact posterior capsule, four (28.6%) had a corneal perforation, and three (21.4%) had a history of dry eye. Gram-negative organisms (7), Staphylococcus aureus (3), streptococcal species (2), and fungi (4) were the most frequently isolated organisms. Coagulase-negative staphylococci were not isolated. Six (42.9%) patients achieved a post-treatment visual acuity of 20/200 or better. Three (21.4%) patients underwent enucleation or evisceration. Although not statistically significant, there was an association between appropriate initial antibiotic therapy and improved visual outcomes. Conclusion: Patients in whom endophthalmitis associated with microbial keratitis develops have a frequent history of corticosteroid use, systemic conditions associated with relative immune dysfunction, lack of an intact posterior capsule, dry eye, wound abnormalities, and/or corneal perforation. In general, agents cultured consisted of organisms less frequently reported to be the causative agents in series of postoperative and post-traumatic endophthalmitis. Post-treatment visual outcomes generally were poor.
Risk factors in microbial keratitis leading to penetrating keratoplasty
Ophthalmology, 1999
To determine the characteristics of infectious corneal ulcers at the time of presentation to the cornea specialist associated with a favorable response to medical therapy versus a poor outcome manifested by the need for penetrating keratoplasty for therapy or visual rehabilitation. Design: Retrospective, case-control study. Participants: A total of 162 patient records were reviewed, including the study group of 30 patients and the control group of 132 patients. Intervention: A retrospective review of all cases of microbial keratitis presenting to the Cornea Service between January 1, 1989 and December 31, 1995 was conducted. The cases were divided into two groups. The study group consisted of patients with microbial keratitis who failed medical therapy and required penetrating keratoplasty. The control group included patients with infectious ulcers who responded to medical therapy alone. Main Outcome Measures: The influence of demographics, medical and ocular history, delay in presentation to the primary ophthalmologist or the corneal specialist, topical medications, and contact lens usage were compared. Visual acuity and ulcer characteristics were recorded. The statistical significance was evaluated by the chi-square test for independence and multiple logistic regression. Results: Older age (Pϭ0.001), delay in referral to the corneal specialist (PϽ0.03), and treatment with topical steroids prior to presentation (PϽ0.0001) were statistically significant factors associated with the need for penetrating keratoplasty. Steroid use and the delay in referral were correlated. A past history of ocular surgery (Pϭ0.01), poor visual acuity at presentation (PϽ0.001), and ulcer characteristics, including central location (PϽ0.0001), large size (PϽ0.0001), presence of perforation or descemetocele (PϽ0.0001), limbal involvement (PϽ0.0001), and hypopyon (Pϭ0.05), were all associated with the need for penetrating keratoplasty. Conclusions: Older age, delay in referral to the corneal specialist, topical steroid treatment, past ocular surgery, poor vision at presentation, large size, and central location of the ulcer are risk factors for poor outcome of microbial keratitis, as indicated by the need for penetrating keratoplasty.