Bacterial Keratitis Follow-up

  • Author: Fernando H Murillo-Lopez, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Nov 3, 2011
 

Further Inpatient Care

  • The frequency of antibiotic administration should be tapered off gradually according to the clinical improvement using some of the following parameters:
    • Blunting of the perimeter of the stromal infiltrate
    • Decreased density of the stromal infiltrate
    • Decreased stromal edema and endothelial inflammatory plaque
    • Decreased anterior chamber inflammation and reepithelialization of the corneal epithelial defect
  • Improvement of patient's symptoms
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Further Outpatient Care

  • Patients need to be monitored closely to make certain the infection is responding to treatment as the medications are tapered.
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Inpatient & Outpatient Medications

  • The antibiotic medications are decreased slowly, depending on the culture and sensitivity results and the clinical response. If topical steroids are used, the antibiotic should not be discontinued.
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Deterrence/Prevention

  • Topical antibiotics are given routinely after traumatic injury to the cornea (including surgery).
  • Preventing contamination of topical medications and the use of sterile contact lens solutions are critical steps in preventing contact lens-related infections.
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Complications

  • The most feared complication of this condition is thinning of the cornea, secondary descemetocele, and eventual perforation of the cornea that may result in endophthalmitis and loss of the eye.
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Prognosis

  • The visual prognosis depends on several factors, as outlined below, and may result in a mild-to-severe decrease in best-corrected visual acuity.
    • Virulence of the organism responsible for the keratitis
    • Extent and location of the corneal ulcer
    • Resulting vascularization and/or collagen deposition
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Patient Education

  • Patients who are contact lens wearers (in particular extended-wear contact lenses) should be instructed not to force the use of contact lenses when they have hyperemia, irritation, or foreign body sensation, and to use sterile contact lens solutions to avoid contamination.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Corneal Ulcer.
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Contributor Information and Disclosures
Author

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Jack L Wilson, PhD  Distinguished Professor, Department of Anatomy and Neurobiology, University of Tennessee Health Science Center College of Medicine

Jack L Wilson, PhD is a member of the following medical societies: American Association of Anatomists, American Association of Clinical Anatomists, and American Heart Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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