1/7. Bacterial keratitis associated with vernal keratoconjunctivitis.We cared for two patients with longstanding vernal keratoconjunctivitis who had bacterial corneal ulcers in each eye. Both patients were young, black, and had histories of atopy. The patients came for treatment with acute symptoms of pain, redness, and reduced vision in the affected eye. On examination in each case we found an epithelial defect associated with dense stromal infiltration, a calcific plaque in the bed of the ulcer, and a severe anterior chamber reaction, including a hypopyon in two cases. Cultures of corneal scrapings from all four eyes were positive for staphylococcus aureus, and three of the four infections were polymicrobial. All four eyes responded rapidly to intensive topical antibiotic therapy, debridement of the calcific plaque, and subsequent treatment with topical corticosteroids and/or cromolyn sodium. Bacterial keratitis can occur in patients with vernal keratoconjunctivitis, especially those with vernal corneal ulcers. The abnormalities of ocular immune mechanisms found in patients with vernal keratoconjunctivitis may predispose them to bacterial keratitis.- - - - - - - - - - ranking = 1keywords = keratoconjunctivitis (Clic here for more details about this article) |
2/7. Persistent superficial punctate keratitis after resolution of chlamydial follicular conjunctivitis.Two cases of follicular conjunctivitis due to chlamydia trachomatis followed by punctate epithelial keratitis are described. Both cases were initially treated with either oral tetracycline or doxycycline with resolution of the follicles. These two patients subsequently had recurrent, bilateral grayish lesions at various levels in the corneal epithelium that stained in a punctate fashion with fluorescein. There was anterior stromal edema associated with some of these lesions in one case. The lesions were confined mostly to the central cornea. These recurrent lesions were unassociated with a conjunctival reaction, were unresponsive to oral tetracycline, but were exquisitely responsive to low doses of topical steroids. Chlamydial conjunctivitis and the associated keratitis typically shows no response or actual exacerbation of symptoms with topical steroids, and the keratitis shows a predilection for the upper half of the cornea. These patients demonstrate that chlamydial keratoconjunctivitis might result in a clinical appearance consistent with Thygeson's superficial punctate keratitis.- - - - - - - - - - ranking = 0.14285714285714keywords = keratoconjunctivitis (Clic here for more details about this article) |
3/7. Bilateral dacryocystitis after punctal occlusion with thermal cautery.A 61-year-old woman developed acute bilateral dacryocystitis secondary to staphylococcus aureus 3 weeks after undergoing punctal occlusion with thermal cautery for keratoconjunctivitis sicca. The dacryocystitis resolved with intravenous antibiotics, aspiration of the lacrimal sacs, injection of sulfacetamide into the lacrimal sacs, and bilateral dacryocystorhinostomy. Preexisting bilateral nasolacrimal duct obstruction was postulated as the underlying cause. In these cases, irrigation of the lacrimal system is recommended before proceeding with punctal occlusion.- - - - - - - - - - ranking = 0.14285714285714keywords = keratoconjunctivitis (Clic here for more details about this article) |
4/7. pseudomonas aeruginosa keratitis in an atopic silicone hydrogel lens wearer with rosacea.PURPOSE: This case report documents pseudomonas aeruginosa corneal infection associated with daily wear of a silicone contact lens in a patient who also had bilateral, preexisting biomicroscopic findings of ocular rosacea, seborrheic blepharitis, keratoconjunctivitis sicca, and chronic punctate corneal epitheliopathy. CONCLUSIONS: Collectively, these problems produce increased risk of infection for wear of any contact lens; and underscore the importance of proper patient selection, education and post-fit monitoring even when hyper-oxygen transmitting silicone hydrogels are utilized.- - - - - - - - - - ranking = 0.14285714285714keywords = keratoconjunctivitis (Clic here for more details about this article) |
5/7. Secondary bacterial keratitis associated with shield ulcer caused by vernal conjunctivitis.PURPOSE: To report a patient with vernal keratoconjunctivitis-induced shield ulcer superinfected with staphylococcus aureus. methods: Observational case report. A 12-year-old boy who had been followed for vernal keratoconjunctivitis for 3 years was admitted to our clinic complaining of visual loss, photophobia, and a ropy discharge. On slit-lamp examination, a transversely oval shield ulcer, which was situated in the center of the superior third of the cornea, was seen in the left eye. The vernal corneal plaque area and margins were infiltrated, and hypopyon was also observed. With the diagnosis of shield ulcer with secondary bacterial keratitis and hypopyon, the patient underwent medical treatment consisting of topical fortified cefazolin (50 mg/mL) and tobramycin (14 mg/mL), lodoxamide 0.1%, prednisolone acetate 1%, cyclopentolate, and systemic cetirizine. RESULTS: After treatment, the bacterial keratitis, shield ulcer, and inflammation in the anterior chamber disappeared. CONCLUSION: Bacterial keratitis associated with shield ulcer may be rarely observed in patients with vernal keratoconjunctivitis. Prompt diagnosis and treatment may prevent permanent complications and vision loss.- - - - - - - - - - ranking = 0.42857142857143keywords = keratoconjunctivitis (Clic here for more details about this article) |
6/7. Infectious crystalline keratopathy caused by candida albicans.Two patients developed corneal opacities resembling infectious crystalline keratopathy. Predisposing factors included a recent corneal transplant with suture replacement in one patient and postradiation keratoconjunctivitis with disposable therapeutic contact-lens wear in the other patient. Both patients were using a topically applied corticosteroid and an aminoglycoside antimicrobial. Smears of corneal scrapings showed numerous yeasts without inflammatory cells. Culturing yielded candida albicans and staphylococcus haemolyticus in the first case and C. albicans and S. epidermidis in the second case. Combined antifungal and antimicrobial therapy, with initial withdrawal of corticosteroid use, was effective. The microbial cause of pauci-inflammatory keratitis includes not only viridans streptococci and other bacteria but fungi as well.- - - - - - - - - - ranking = 0.14285714285714keywords = keratoconjunctivitis (Clic here for more details about this article) |
7/7. Incomplete Reiter's syndrome with focal involvement of the posterior segment.PURPOSE: To describe an unusual variant of yersinia-induced, HLA-B27 associated incomplete Reiter's syndrome with focal involvement of the posterior segment. methods: review of case records of a patient presenting with incomplete Reiter's syndrome which included a reactive arthritis with keratoconjunctivitis and anterior uveitis. RESULTS: The uveitis progressed to involve the posterior segment with a vitritis and two transient white retinal spots. After resolving, a retinal pigment epithelial (RPE) defect persisted at the site of one of the lesions. CONCLUSIONS: While involvement of the anterior segment of the globe in Reiter's disease is well recognised, a review of the literature reveals that focal posterior involvement is a rare feature in either Reiter's syndrome or the reactive arthritis group.- - - - - - - - - - ranking = 0.14285714285714keywords = keratoconjunctivitis (Clic here for more details about this article) |