Tistoryview

 

 

👁 “Bacterial Keratitis – A Sight-Threatening Ocular Emergency”

Bacterial keratitis is a sight-threatening corneal infection, particularly concerning in contact lens users or those with prior ocular trauma or surgery.
Modern antibiotics have reduced systemic infections, but corneal ulcers remain a major cause of irreversible vision loss.


🧠 Risk Factors for Bacterial Keratitis

CategoryRisk Details
Trauma Corneal abrasion, foreign body, chemical insult
Contact lenses  
– All types involved  
– Risk: Extended wear > Daily wear > RGP ≒ Disposable  
– Silicone hydrogel does not reduce infection rate  
Ocular surface disease Dry eye, chronic inflammation, therapeutic lenses
Refractive surgery LASIK, RK → even years later
Immunocompromised AIDS: no higher incidence, but severe progression once infected

🦠 Causative Organisms & Progression Speed

SpeedTypical Pathogens
Fast Staph. aureus, Pseudomonas, Strep. pyogenes, Pneumococcus
Slow Nontuberculous Mycobacteria, Nocardia, Actinomyces, Moraxella

⚠️ Clinical Red Flags for Severe Ulcer

IndicatorClinical Concern
Central corneal ulcer Vision-threatening location
Ulcer >6mm in size Severe infiltration
Deep stromal invasion >1/3 thickness = high risk
Imminent or actual perforation Urgent surgery indicated
Scleral extension Sign of sclerokeratitis, requires aggressive treatment

💉 Surgical Consideration Triggers

  • Subconjunctival antibiotics
  • Systemic antibiotics
  • Therapeutic PKP (penetrating keratoplasty) for perforation or unresponsive cases
Notices
Recents
Comments
Total
Today
Yesterday
Links
TAG
more
«   2025/05   »
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31
Boxs