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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The author evaluated 142 patients aged 65 years or older with microbial keratitis. There were relatively high rates of Pseudomonas aeruginosa infection unassociated with contact lens wear and of Streptococcus pneumoniae infection. The rates of quasicommensal and enteric infections were not proportionately elevated. Corneal disease, use of topical corticosteroids and use of contact lenses were the main predisposing factors. Patients with diabetes mellitus, dementia or chronic alcoholism appeared to be at higher risk. Trauma was rarely a factor. Complications requiring surgery were common. Corneal perforation developed in 20% of the patients, and endophthalmitis developed in 6%. The elderly often do not tolerate intensive topical antibiotic treatment well. Supplementary subconjunctival antibiotic injections under local anesthesia may be necessary. Corneal tissue glue, tarsorrhaphy and conjunctival flaps are probably underused in this age group.
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PMID:Causes and management of bacterial keratitis in the elderly. 273 Oct 71

Staphylococcus epidermidis accounts for nearly one third of all cases of bacterial keratitis in certain geographic areas. Recently, the sensitivity of this organism has changed dramatically so that nearly half of nosocomially acquired systemic S epidermidis infections are resistant to methicillin sodium, cephalosporins, and aminoglycosides. Methicillin-resistant and gentamicin sulfate-resistant S epidermidis causing infectious blepharoconjunctivitis and endophthalmitis has previously been reported. Two cases of methicillin- and gentamicin-resistant S epidermidis keratitis occurred that were treated successfully with topical vancomycin hydrochloride.
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PMID:Methicillin-resistant Staphylococcus epidermidis keratitis treated with vancomycin. 319 May 43

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.
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PMID:Marginal corneal abscess associated with adult chlamydial ophthalmia. 319 Oct 80

The authors report 19 cases of exogenous fungal endophthalmitis managed between 1969 and 1986. These developed after ocular surgery (5 cases), after trauma (6 cases), by intraocular spread from fungal keratitis (4 cases), after therapeutic keratoplasty for keratitis (3 cases), and by spontaneous infection of a filtration bleb (1 case). The diagnosis of endophthalmitis was made from 3 days to 4 months after surgery or trauma. In patients with preexisting keratitis, endophthalmitis was noted 2 weeks to 5 months after the onset of keratitis. Seventeen cases were caused by filamentous fungi; two were caused by yeast. Fusarium (6 cases) and Acremonium (3 cases) accounted for approximately one half of the isolates. Forty-two percent of the patients recovered 20/400 or better acuity (3 of 5 postoperative cases, 4 of 6 trauma cases, and 1 of 4 keratitis cases). The clinical and microbiologic features of these cases are presented, and recommendations for management are offered.
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PMID:Exogenous fungal endophthalmitis. 325 18

Selman Waksman's laboratory at Rutgers University discovered the first aminoglycoside antibiotic, streptomycin, in 1943. Other aminoglycoside antibiotics, such as gentamicin and tobramycin, soon followed. Tobramycin is compatible with most intravenous fluids and tear substitutes, but it is incompatible with heparin and some beta-lactam antibiotics such as penicillin and cephalosporins. Due to tobramycin's broad spectrum of activity, it has proven useful in controlling both superficial and deep infections of the eye and ocular adnexa (i.e., blepharitis, conjunctivitis, keratitis, and endophthalmitis). However, since tobramycin has been associated with neuromuscular blockade, as well as possessing ototoxic and nephrotoxic effects, care must be taken to minimize toxicity by monitoring patients undergoing systemic tobramycin therapy.
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PMID:Tobramycin in ophthalmology. 331 53

In a new surgical procedure, adverse reactions or complications may surface without most ophthalmic surgeons experiencing them or being aware of them. Even those with a large series of cases may never see certain problems. Through a collaborative effort with over 200 radial keratotomy surgeons totaling 63,000 cases nearly every significant complication has been documented. This study of radial keratotomy complications includes the number of patients and percentage of the total of the following: intraoperative occurrences which generally do not affect vision, which include microperforations and macroperforations; postoperative changes which do not affect vision: limbal "peeking" and star pattern with light; transient occurrences which tend to resolve with time: ptosis, recurrent erosions, corneal ulcer, microwound abscess, delayed wound healing, inferior rectus palsy, glare or fluctuating vision after six months, iritis, and stromal keratitis; postoperative changes which can affect vision (correctible): overcorrection more than 1.5 diopters, marked undercorrection more than -2.00 diopters, irregular astigmatism, neovascularization after soft-contact-lens wear, and best-corrected acuity decreased usually only one line; and postoperative changes which can affect vision (uncorrectible): retrobulbar hemorrhage and endophthalmitis, loss of the eye, herpes keratitis, and cataract formation.
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PMID:Radial keratotomy complications. 342 39

One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. Herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin A deficiency was the major cause of bilateral ulceration, subsequent blindness, and mortality in this series. Other significant causes of childhood corneal ulceration were the use of traditional eye medicines, confluent measles keratitis, and ophthalmia neonatorum. We discuss the various mechanisms by which measles causes corneal ulceration, and the priorities in prevention and management of corneal ulceration in African children.
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PMID:Corneal ulceration, measles, and childhood blindness in Tanzania. 358 Mar 49

The spitting cobra (Naja nigricollis) can eject its venom into its adversary's eyes from a distance of several meters. This causes an immediate and painful conjunctival infection, followed by blepharospasm, corneal and conjunctival edema, and erosion. Corneal ulcer, in some cases with perforation, hypopyon and endophthalmitis are the results. The present paper reports on a 35-year-old patient from Hemkoa (South Upper Volta) whose eyes had been affected by the venom of a spitting cobra 5 years previously. The patient had meanwhile lost his sight as a result of bilateral sclerosing keratitis. The possible influence of the patient's basic disease (onchocerciasis) on the course of the sclerosing keratitis is discussed.
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PMID:[Spitting cobra ophthalmia (Naja nigricollis)]. 633 38

Unilateral keratitis developed in a 31-year-old man following superficial corneal injury with vegetable foreign material. The corneal inflammation progressed to perforation and endophthalmitis. Nocardia asteroides was eventually identified in an aspirate from the anterior chamber. Aggressive medical and surgical treatment resulted in salvage of the globe and a visual acuity of 6/15. Controversial aspects of the management of this problem are considered.
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PMID:Nocardia keratitis. 638 59

Acute ocular complications of erythema multiforme such as infection causing conjunctivitis, suppurative keratitis or endophthalmitis are well recognized and usually easily managed. Late complications include disorders to tear production and drainage, position of lids, abberant or metaplastic lashes and metaplasia of the conjunctiva. Early detection and active management of these abnormalities greatly improves the long term prognosis. The techniques employed and the indications for their use in a recent series of 34 patients are presented.
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PMID:The ocular complications of erythema multiforme (Stevens Johnson syndrome) and their management. 658 76


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