A29 year old woman, who was an intermittent contact lens wearer, is referred from her local ophthalmologist with a diagnosis of microbial keratitis. There is a large central corneal ulcer with stromal white cell recruitment and low grade anterior chamber (AC) activity. The patient has no other eye problems and is in good health. Would you perform a corneal scraping? Which antibiotics would you ...

This study was a retrospective study on corneal ulcer of one year period in Hospital Ipoh. A total of 28 cases were studied. Among the risk factors identified were foreign body on cornea, trauma, contact lens, vernal keratoconjunctivitis and surgical complication. The nature of this disease which was severe and slow healing caused prolonged hospital admission. Identification of causative microo...

PURPOSE Corneal ulcer results from excessive collagen degradation in the corneal stroma. Interleukin (IL)-1 promotes this process by activating signaling molecules that include nuclear factor (NF)-kappaB and stimulating the synthesis of matrix metalloproteinases (MMPs) in corneal fibroblasts. NF-kappaB activation is mediated by phosphorylation of the inhibitor IkappaB by IkappaB kinase (IKK)-2 ...

Method Secretion of both proinflammatory cytokine interleukin (IL)-1α and tumor necrosis factor (TNF)-α was measured after cultivation of 47 corneas collected from corneal graft recipients suffering from different corneal diseases. Non-inflammatory corneal diseases were keratoconus (n = 8), keratoglobus (n = 2), bullous keratopathy (n = 11), and Groenouw stromal dystrophy type II (n = 2), where...

Nocardia asteroides is a rare cause of keratitis usually associated with trauma. We report a case of corneal ulceration caused by N. asteroides in a patient with leprosy. This is the first case report of nocardial keratitis from Southeast Asia. The diminished corneal sensation in a patient with leprosy could be a predisposing factor for development or exacerbation of corneal ulceration.

Sloughing virulent corneal ulcers are still very common in India. Even with the best medication they often fail to respond and in such cases the eyes are invariably lost. This is especially true in the case of ulcers caused by Pseudomonas pyocyaneus, when the clinical course is so fulminating that only a bold and timely decision can save the eye. Keratoplasty has been found to be a potent eye-s...

Pseudomonas aeruginosa was isolated from the corneal scrapings of 11 of 14 patients with gram-negative corneal ulcers and fromi salt tablet-prepared saline solutions from 6 of these patients wearing soft contact lenses. Comparison of physiological properties, antibiograms, serotypes, and plasmid profiles for five of the patients indicated that the isolates from the ulcer and the saline solution...

Current medical treatments of non infected resistant corneal ulcer include topical artificial tears, lubricants [1] and experimental trials of fibronectin [2], insulin-like growth factor type I [3] and substance P [3], autologous serum [4] or nerve growth factor [5]. When these medical therapies fail, one may consider patching, scleral contact lens, cyanoacrylate glue [6], conjunctival flap, ta...

A review of 100 patients who underwent penetrating keratoplasty revealed 47 who required therapeutic soft contact lenses in the early postoperative period. Twelve corneal ulcer-infiltrates, 11 of which were culture positive, occurred during soft contact lens wear (23% incidence of this complication in contact lens fitted eyes). The most common offending organism was coagulase-negative staphyloc...

Bullous keratopathy (BK) entails an irreversible corneal edema secondary to the failure of the endothelial pump. Its poor response tomedical treatment and its disabling clinical symptomatology has given rise to the appearance of a range of medical treatments, although the majority of patients end up requiring a corneal or endothelial transplant. Recently, cross-linking has began to be hailed as...