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Bacterial keratitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Bacterial infection of the corneum usually follows an injury and corneal ulcers and infiltrates should initially be assumed to be bacterial, unless a high index of suspicion exists for another aetiology.

Common causative organisms include (1,2):

  • coagulase-negative staphylococci
  • pseudomonas aeruginosa
  • corynebacterium spp.
  • staphylococcus aureus
  • streptococcus spp.
  • Mycobacteria also has been isolated (3)

Infection with ulceration is accompanied by symptoms such as:

  • gritty pain
  • photophobia
  • lacrimation
  • blurred vision

Corneal oedema is seen as greyness or opacity.

Severe keratitis is associated with large diameter lesions, infiltration of stroma, and inflammation of the anterior chamber (4).

Fluorescein staining will demarcate any areas of ulceration.

The eye should be inspected thoroughly for the presence of a foreign body.

Reference:

  1. Eye Contact Lens. 2007 Jan;33(1):45-9.
  2. Clin Experiment Ophthalmol. 2006 Jan-Feb;34(1):44-50.
  3. Ophthalmologe. 2007 Jan;104(1):9-14
  4. J Fr Ophtalmol. 2007 Apr;30(4):423-30.

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