1/50. Bilateral Pseudomonas corneal ulcer in a disposable contact lens wearer.PURPOSE: To describe a case of bilateral corneal ulcers caused by Pseudomonas in a disposable soft contact lens wearer. This case study discusses the role of patient examination, contact lens care instruction, and adequate patient supervision in reducing the risk of serious potential complications. methods AND RESULTS: A 17 year old student who had been using disposable soft contact lenses on an extended wear basis for 6 months presented complaining of pain in the left eye. When he was examined, a corneal ulcer with surrounding infiltrate was observed in the superior middle periphery of the left eye. Samples were collected for culture, and treatment with fortified cefalotin and gentamicin was started. After 8 hours the patient returned, now complaining of pain in the right eye. Examination of the right eye revealed a diffused keratitis with a mucopurulent discharge. A culture was taken, and the same treatment was instituted. The laboratory tests revealed Pseudomonas in both eyes. The bilateral corneal ulcers responded to therapy after 1 week of treatment. CONCLUSIONS: We discuss the factors involved in the occurrence of infectious keratitis in contact lens wearers, and stress that even disposable contact lens wear can be associated with serious complications. This case also highlights extended wear as one of the main risk factors for complications in disposable soft contact lens wear.- - - - - - - - - - ranking = 1keywords = wear (Clic here for more details about this article) |
2/50. Unusual case of acanthamoeba polyphaga and pseudomonas aeruginosa keratitis in a contact lens wearer from Gauteng, south africa.acanthamoeba species can cause a chronic, progressive ulcerative keratitis of the eye which is not responsive to the usual antimicrobial therapy and is frequently mistaken for stromal herpes keratitis. An unusual case of coinfection with acanthamoeba polyphaga and pseudomonas aeruginosa as causes of corneal keratitis in a contact lens wearer from Gauteng, south africa, is reported. These two pathogens have previously been assumed to be selectively exclusive. cysts of the isolated acanthameba tolerated an incubation temperature of 40 degrees C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen. The patient's history of careless contact lens-disinfecting habits emphasizes the need to adhere strictly to recommended methods of contact lens care.- - - - - - - - - - ranking = 0.5keywords = wear (Clic here for more details about this article) |
3/50. Severe sclerokeratitis due to pseudomonas aeruginosa in noncontact-lens wearers.PURPOSE: To review the clinical presentation, treatment and outcome in four cases of severe anterior segment infection by pseudomonas aeruginosa unrelated to contact lens wear. methods: Four cases presenting over an 18 month period were reviewed. RESULTS: The cases had variable presenting features and outcomes. Complications such as persistent infection, corneal thinning and phthisis bulbi were noted. Possible factors influencing adherence and tissue disruption are discussed. CONCLUSIONS: Suspicion of infection by P. aeruginosa and prompt isolation of the organism is needed early in the course of disease. Intensive and prolonged treatment with parenteral and topical antibiotics combined with judicious use of topical steroid gives the best chance of a favourable outcome.- - - - - - - - - - ranking = 0.5keywords = wear (Clic here for more details about this article) |
4/50. Subdural and intraventricular traumatic tension pneumocephalus: case report.Simple pneumocephalus most frequently arises as a complication of a head injury in which a compound basal skull fracture with tearing of the meninges allows entry of air into the cranial cavity. It can also follow a neurosurgical operation. Tension traumatic pneumocephalus with intraventricular extension is an extremely rare, potentially lethal condition that requires prompt diagnosis and treatment. We report the case of subdural and intraventricular accidental tension pneumocephalus occurring in a 26-year-old man as a result of skull fracture. This case is combined with rhinorrhea and meningitis that suggest some difficulties to treat. The operative procedure associated with medical treatment was performed and a good result was obtained.- - - - - - - - - - ranking = 0.00027303464666313keywords = dental (Clic here for more details about this article) |
5/50. Infectious keratitis in orthokeratology.Orthokeratology is a method of changing refraction in myopic patients by using rigid contact lenses to reduce the curvature of the cornea. This treatment was in use in the two cases of corneal ulcer described in this paper and appears to have contributed to the development of their disease. As with extended wear contact lenses, patients undergoing orthokeratology treatment are frequently advised to wear the orthokeratology lenses overnight increasing the risk of corneal ulceration and infection. patients should be adequately warned of the associated risks and advised that any envisaged benefits of the procedure are temporary.- - - - - - - - - - ranking = 0.2keywords = wear (Clic here for more details about this article) |
6/50. Clinical presentation of microbial keratitis with daily wear frequent-replacement hydrogel lenses: a case series.Microbial keratitis (MK) is a serious complication associated with contact lens wear. In this case series we report three clinical presentations of MK associated with daily-wear monthly-replacement soft contact lenses. All of these patients were using vifilcon A (55% water content, ionic, U.S. food and Drug Administration [FDA] group IV) monthly-replacement soft contact lenses. A gram-stained smear of the corneal scrapings of two patients showed numerous gram-negative cocci bacilli, and tissue cultures showed significant growth of pseudomonas aeruginosa. In the third patient, the corneal scrapings showed numerous gram-negative bacilli, along with gram-positive cocci, and tissue culture showed significant growth of aeromonas species and alpha-hemolytic streptococci. All these cases were resolved by medical therapy. This case series highlights the importance of patient symptoms, clinical features, and microbiologic work-up in making a differentiation between MK and sterile contact lens-induced peripheral ulcer (CLPU). A high index of suspicion and close follow-up care will avoid misdiagnosis and reduce complications.- - - - - - - - - - ranking = 0.6keywords = wear (Clic here for more details about this article) |
7/50. Pseudomonas corneal ulcer related to overnight orthokeratology.PURPOSE: To report two cases of pseudomonas aeruginosa corneal ulcers as a complication of overnight orthokeratology lens wear. methods: Case report. RESULTS: Two 11-year-old girls with acute central corneal ulcers were referred to our hospital. In both cases, the ulcers were about 2 mm in diameter, located centrally, contained dense cellular infiltration, and discharged purulent material. Intensive topical ceftazidime was applied to treat the ulcers. Cultures of the scraped corneal tissues and the contact lens storage solutions in both cases grew P. aeruginosa, which was sensitive to the antibiotic. The presenting best-corrected visual acuity was hand motion at 20 cm in one patient and 6/20 in the other. Both patients had received several months of overnight orthokeratology treatment with rigid gas permeable contact lenses to correct myopia (-4.25 D and -4.75 D in the two affected eyes). The final best-corrected visual acuity was 6/60 in one patient and 6/7.5 in the other. CONCLUSIONS: Overnight orthokeratology contact lens wear carries a potential risk of corneal ulcer and may cause significant visual impairment in children.- - - - - - - - - - ranking = 0.2keywords = wear (Clic here for more details about this article) |
8/50. Orthokeratology lens-related pseudomonas aeruginosa infectious keratitis.PURPOSE: To report a case of orthokeratology lens-related Pseudomonas corneal ulcer in an adult. methods: Case report. RESULTS: A 37-year-old man presented with a 1-day history of painful red eye. He was a soft contact lens wearer before he started on nocturnal orthokeratology lens wear of 8 to 10 hours per night 9 months ago. Corneal scraping sent for culture revealed a heavy growth of pseudomonas aeruginosa. The patient was treated with intensive topical fortified tobramycin and ceftazidime drops. The ulcer healed with a residual paraxial corneal scar. Although his best-corrected visual acuity (BCVA) recovered from finger counting (8/200) at presentation to 20/30, he suffered visual loss from a premorbid BSCVA of 20/15. His contrast sensitivity (Vector Vision CSV 1000 test) performance was also worse than his fellow eye. CONCLUSION: Nocturnal orthokeratology lens wear may be associated with an increased risk of infection.- - - - - - - - - - ranking = 0.3keywords = wear (Clic here for more details about this article) |
9/50. Infectious keratitis associated with daily disposable contact lenses.PURPOSE: To report two cases of infectious keratitis associated with the use of daily disposable soft contact lenses. METHOD: Two case reports of individuals who developed infectious keratitis while wearing daily disposable soft contact lenses are presented. RESULTS: The first case is that of a 34-year-old woman who had been using daily disposable soft contact lenses for 18 months before she developed a corneal ulcer in her left eye. The cultures grew pseudomonas aeruginosa, and she was treated successfully with fortified topical antibiotics. The second case describes a 30-year-old woman who had been using conventional soft contact lenses for 5 years before switching to daily disposable soft contact lenses 3 months before presentation. She was found to have a corneal ulcer in her left eye that grew staphylococcus aureus on cultures, and she responded to topical antibiotic treatment. CONCLUSIONS: Although daily disposable soft contact lenses theoretically have a lower risk of infectious keratitis compared with other lens wear regimens, reports have shown that at least some risk remains. These lenses should be prescribed and used with great care to minimize contact lens-related infectious keratitis.- - - - - - - - - - ranking = 0.2keywords = wear (Clic here for more details about this article) |
10/50. Unusual morphology in orthokeratology contact lens-related cornea ulcer.PURPOSE: To report a case of unusual ulcer morphology in orthokeratology-related corneal ulcer. methods: A single observational case report of a 14-year-old Chinese female myope with a 1.5-month experience wearing overnight B.E. orthokeratology (Capricornia) lenses and presenting with a right stellate-shaped central cornea abscess. Cornea scrapings for Gram stains, culture, and antibiotic sensitivity were performed. The patient was prescribed hourly fortified cefazolin and gentamicin drops. RESULTS: pseudomonas aeruginosa grew on blood and chocolate agar cultures. The ulcer was successfully treated with antibiotics and reepithelialized over 5 days. There was a residual central corneal scar. The refraction changed from -4.25 sphere OD and -1.75 -1.75 x160 OS to -3.50 -1.50 x160 OD and -1.50 -1.75 x165, giving a visual acuity of 20/ 25 OD and 20/20 OS. CONCLUSIONS: A flatter fit of orthokeratology lenses may be associated with unusual cornea ulcer morphology.- - - - - - - - - - ranking = 0.1keywords = wear (Clic here for more details about this article) |
| | Next -> |