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1. Keratitis

Keratitis Keratitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Keratitis Last reviewed: February 2019 Last updated: March 2018 Summary This disorder is an ocular emergency and remains one of the major causes of blindness around the world. Main risk factors include corneal trauma, contact lens wear, and breakdown of the corneal epithelium. The diagnosis depends on a careful history, slit-lamp examination (...) , and corneal scraping cultures. Treatment consists of topical antimicrobial agents that may be supplemented by pupil-dilating agents, analgesics, corticosteroids, and systemic antimicrobials as needed. Complications include corneal scarring, perforation, and endophthalmitis. Definition Infectious keratitis refers to microbial invasion of the cornea causing inflammation and damage to the corneal epithelium, stroma, or endothelium. Non-infectious keratitis is, for the most part, rare. History and exam

2018 BMJ Best Practice

2. In vitro antimicrobial activity of diacerein on 76 <b>gram-positive cocci isolates from bacterial keratitis patients and an in vivo study of diacerein eye drops on <i>Staphylococcus aureus</i> keratitis in mice</b>. (PubMed)

In vitro antimicrobial activity of diacerein on 76 gram-positive cocci isolates from bacterial keratitis patients and an in vivo study of diacerein eye drops on Staphylococcus aureus keratitis in mice. Bacterial keratitis is an aggressive infectious corneal disease. With the continuing rise in antibiotic resistance and a decline in the discovery of new antibiotics, new antimicrobial drugs are now required. In the present study, we determined the antibacterial activity of diacerein (...) , an anti-inflammatory drug, against 76 Gram-positive cocci isolated from bacterial keratitis patients in vitro and anti-Staphylococcus aureus activity in mouse bacterial keratitis model in vivo. The minimum inhibitory concentrations (MICs) of diacerein were tested using the broth microdilution method in vitro. A BALB/c Staphylococcus aureus keratitis animal model was selected and the corneal clinical observation, viable bacteria and Hematoxylin-eosin and Gram staining of infected corneas were measured

2019 Antimicrobial Agents and Chemotherapy

3. Human adenoviral type 54 keratoconjunctivitis accompanied by stellate keratitis and keratic precipitates: two cases. (PubMed)

Human adenoviral type 54 keratoconjunctivitis accompanied by stellate keratitis and keratic precipitates: two cases. Of the 10 patients with adenoviral type 54 keratoconjunctivitis examined at Nojima Hospital, 2 developed stellate keratitis and mutton-fat keratic precipitates (KPs) following acute symptoms.We encountered 10 cases of epidemic keratoconjunctivitis from August to October 2017. All patients were adults with a mean age of 60.9 ± 10.0 years. The species D human adenovirus (HAdV)-54 (...) was detected in the conjunctival scrapings of these patients. Fluorometholone instillation was administered during the first week for acute symptomatic relief. Case 1: A 64-year-old female was prescribed with fluorometholone instillation, which was discontinued after 1 week when her symptoms alleviated. One week after discontinuation of the instillation, she presented with blurred vision in her left eye with KPs and multiple stellate keratitis. The anterior chamber had no apparent cells. Her symptoms

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2019 BMC Ophthalmology

4. Keratitis, CL-associated infiltrative

Keratitis, CL-associated infiltrative Keratitis, CL-associated infiltrative submit The College submit You're here: Keratitis, CL-associated infiltrative Keratitis, CL-associated infiltrative The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Contact lens-associated infiltrative events, including: contact lens-associated peripheral ulcer (...) (CLPU) contact lens-associated infiltrative keratitis The aetiology of this condition is inflammatory, not infective. Though it is bacteria-related, bacteria do not invade or replicate in the cornea and there is no progression to infection, nor is the condition a marker for increased risk of microbial keratitis, which is a separate disease entity CL-associated infiltrative keratitis is considered to be a response to microbial (usually Staphylococcal ) antigens, derived from bacteria on the lens

2018 College of Optometrists

5. Herpes Simplex Keratitis

Herpes Simplex Keratitis Herpes Simplex Keratitis (HSK) submit The College submit You're here: Herpes Simplex Keratitis (HSK) Herpes Simplex Keratitis (HSK) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Herpes simplex virus (HSV) infection is extremely common, though usually latent up to 90 (...) % of UK population is seropositive for HSV HSV-1 generally infects ‘above the waist’ (lips, face, eyes) primary infection usually in childhood, then virus lies dormant in trigeminal ganglion when virus reactivates it travels along branches of the trigeminal nerve to cause local infection (e.g. cold sore or herpes keratitis) HSV-2 generally infects ‘below the waist’ and is usually sexually acquired but may also be a cause of herpetic keratitis Ocular HSV infection (of which the incidence of new cases

2018 College of Optometrists

6. Oral antivirals for preventing recurrent herpes simplex keratitis in people with corneal grafts. (PubMed)

Oral antivirals for preventing recurrent herpes simplex keratitis in people with corneal grafts. Ocular herpes is a viral infection of the eye caused by the herpes simplex virus (HSV), a double-stranded DNA virus. Corneal scarring caused by herpes simplex keratitis (HSK) is the leading infectious cause of penetrating corneal graft in high-income countries. Acyclovir is an antiviral drug known to have a protective effect against recurrences in herpetic eye disease. While there are some studies (...) which have evaluated the effects of intervention with oral antiviral in preventing such recurrences in people with corneal grafts, a systematic review of all comparative clinical trials has not been previously undertaken.To assess the efficacy of oral antivirals such as acyclovir in any dosage when taken for six months or more, in preventing recurrence of herpetic keratitis in people having corneal graft surgery for herpetic keratitis.We searched CENTRAL (which contains the Cochrane Eyes and Vision

2016 Cochrane

7. What Is the Most Effective Treatment of Herpes Simplex Keratitis?

What Is the Most Effective Treatment of Herpes Simplex Keratitis? TAKE-HOME MESSAGE Treatmentofherpessimplexviruskeratitiscanbeaccomplishedwitheithertopical tri?uridineorganciclovir,whichhavesimilaref?cacy.Oralacyclovirisanacceptable treatment option in cases for which compliance with a topical ophthalmic regimen may be of concern. What Is the Most Effective Treatment of Herpes Simplex Keratitis? EBEM Commentators Joshua Bucher, MD Rutgers–Robert Wood Johnson Medical School New Brunswick, NJ (...) % con?dence interval [CI] 0.8 to 1.1). 1 Similarly, there was no difference in the primary outcome between interferon treatment and antivirals (RR 1.2; 95% CI 0.9 to 1.6). Commentary It is estimated that herpes simplex virus keratitis has an incidence of approximately12to31peopleper 100,000 annually. 2,3 Although it is a relatively uncommon diagno- sis in the emergency department setting, initiation of appropriate treatment is critical, given the potential to lead to serious visual impairment

2016 Annals of Emergency Medicine Systematic Review Snapshots

8. Atypical presentation of diffuse lamellar keratitis after small-incision lenticule extraction: Sterile multifocal inflammatory keratitis. (PubMed)

Atypical presentation of diffuse lamellar keratitis after small-incision lenticule extraction: Sterile multifocal inflammatory keratitis. We describe a case of atypical diffuse lamellar keratitis (DLK) following small-incision lenticule extraction (SMILE). The patient presented with multiple focal white infiltrates 1 day after routine small-incision lenticule extraction surgery. An interface washout was performed, and the patient was managed with intensive topical steroids. Potential infectious (...) keratitis was also investigated (by culture and Gram stain) and treated aggressively with steroids and antibiotics. The cultures were all negative with no growth, and the focal infiltrates gradually resolved, with no relapses at the 15-month postoperative follow-up and a faint 0.7 mm superior scar in the right eye. This case highlights the importance of using intensive topical steroids as well as performing an interface washout in such cases because of the higher risk for corneal melting associated

2018 Journal of cataract and refractive surgery

9. Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis (PubMed)

Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis This study is to investigate the characteristic features of Acanthamoeba keratitis (AK) that differentiating it from herpetic epithelial keratitis (HEK) using anterior segment optical coherence tomography (AS-OCT). Medical records of three eyes of each AK and herpetic keratitis who had AS-OCT examination were reviewed in this study. Slit-lamp biomicroscopy and AS-OCT

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2018 International journal of ophthalmology

10. The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study Of Infectious Keratitis In Asia. (PubMed)

The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study Of Infectious Keratitis In Asia. To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia.Prospective, nonrandomized clinical study.Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment (...) of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection.A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7

2018 American Journal of Ophthalmology

11. Tacrolimus interacts with voriconazole to reduce the severity of fungal keratitis by suppressing IFN-related inflammatory responses and concomitant FK506 and voriconazole treatment suppresses fungal keratitis (PubMed)

Tacrolimus interacts with voriconazole to reduce the severity of fungal keratitis by suppressing IFN-related inflammatory responses and concomitant FK506 and voriconazole treatment suppresses fungal keratitis To investigate the expression and roles of type I and II interferons (IFNs) in fungal keratitis, as well as the therapeutic effects of tacrolimus (FK506) and voriconazole on this condition.The mRNA and protein expression levels of type I (IFN-α/β) and II (IFN-γ) IFNs, as well as of related (...) downstream inflammatory cytokines (interleukin (IL)-1α, IL-6, IL-12, and IL-17), were detected in macrophages, neutrophils, lymphocytes, and corneal epithelial cells (A6(1) cells) stimulated with zymosan (10 mg/ml) for 8 or 24 h. A fungal keratitis mouse model was generated through intrastromal injection of Aspergillus fumigatus, and the mice were then divided into four groups: group I, the PBS group; group II, the voriconazole group; group III, the FK506 group; and group IV, the voriconazole plus 0.05

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2018 Molecular vision

12. Incidence and Outcomes of Sterile Multifocal Inflammatory Keratitis and Diffuse Lamellar Keratitis After SMILE. (PubMed)

Incidence and Outcomes of Sterile Multifocal Inflammatory Keratitis and Diffuse Lamellar Keratitis After SMILE. To report the incidence outcomes of sterile multifocal inflammatory keratitis and diffuse lamellar keratitis (DLK) after small incision lenticule extraction (SMILE) in a large population.This was a retrospective review of a population of 4,000 consecutive eyes treated by SMILE at the London Vision Clinic using the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany (...) ). The inclusion criterion was to have presented with inflammatory keratitis after SMILE. In some cases after SMILE, the inflammatory keratitis presented as sterile multifocal interface keratitis uncharacteristic of classic DLK. The incidence was measured and categorized as primary or secondary by presenting appearance, grade, and time to presentation. Patients were observed for 1 year after surgery and standard outcomes analysis was performed.Of the 4,000 eye population, there were 18 cases (0.45%) of DLK

2018 Journal of Refractive Surgery

13. Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique (PubMed)

Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique The purpose of this article is to describe the use of simultaneous noncentered photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) combined with penetrating keratoplasty in the treatment of a severe marginal Fusarium spp. keratitis case (...) and effective way of treating patients with fungal marginal keratitis with corneal perforation, in which regular penetrating keratoplasty alone would leave fungal elements in the receptor corneal tissue, which would predispose to infection of the graft.

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2017 Case reports in ophthalmological medicine

14. Microbial keratitis (Acanthamoeba sp.)

Microbial keratitis (Acanthamoeba sp.) Microbial keratitis (Acanthamoeba sp.) submit The College submit You're here: Microbial keratitis (Acanthamoeba sp.) Microbial keratitis (Acanthamoeba sp.) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Acanthamoebae are ubiquitous free-living protozoans (...) , present in: well water, drains, soil, dust may be present in domestic tap water (especially from storage tanks) Can exist in two forms motile, feeding and replicating form: trophozoite (most common form found in water and easily destroyed) dormant form: cyst (highly resistant to disinfection, can survive for long periods in hostile environments) Acanthamoeba keratitis is rare in the general population (estimated annual incidence: 1.4 per million per annum) but much commoner in contact lens wearers

2016 College of Optometrists

15. Microbial keratitis (bacterial, fungal)

Microbial keratitis (bacterial, fungal) Microbial keratitis (bacterial, fungal) submit The College submit You're here: Microbial keratitis (bacterial, fungal) Microbial keratitis (bacterial, fungal) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology The commonest bacterial corneal pathogens (...) are: Pseudomonas sp. (Gram -ve) Staphylococcus sp. (Gram +ve) Streptococcus sp. (Gram +ve) other Gram -ve organisms Note: severe contact lens-related infections tend to be Gram -ve, particularly Pseudomonas species Fungal keratitis is rare in the UK but common in some other parts of the world. The most common fungal corneal pathogens are: Candida sp. (yeast-like) Fusarium sp. (filamentous) Aspergillus sp (filamentous) Predisposing factors Bacterial keratitis is usually associated with one or more

2016 College of Optometrists

16. Correction: Alterations in the gut bacterial microbiome in fungal Keratitis patients. (PubMed)

Correction: Alterations in the gut bacterial microbiome in fungal Keratitis patients. [This corrects the article DOI: 10.1371/journal.pone.0199640.].

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2019 PLoS ONE

17. Chemical conjunctivitis and diffuse lamellar keratitis after removal of eyelash extensions (PubMed)

Chemical conjunctivitis and diffuse lamellar keratitis after removal of eyelash extensions There have been several reports in the literature demonstrating the adverse effects of multiple ocular cosmetic procedures, such as eyelash extensions, eyeliner tattoo, and eyelash dyeing. To our knowledge, there is limited literature on the adverse effects specifically attributed to the chemicals and process of eyelash extension removal. Our purpose is to demonstrate the possible ocular injuries from (...) misapplication of eyelash extension removal solvent.We present a unique case of a 46-year-old female with a prior history of laser assisted in-situ keratomileusis (LASIK) who presented with bilateral chemical conjunctivitis and diffuse lamellar keratitis (DLK) secondary to epithelial defects following the misapplication of eyelash extension removal gel.Given that our patient suffered significant dry eyes, corneal haze, and visual fluctuation, we believe this case underscores the importance of continuing

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2018 American journal of ophthalmology case reports

18. A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis (PubMed)

A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis To describe a case of Stevens-Johnson syndrome (SJS) diagnosed in a patient presenting with primarily ocular findings where SJS had not been initially suspected.A 23-year-old female presented with a 2 day history of bilateral eye pain, conjunctival injection, decreased visual acuity, and photophobia in the context of a 4 day history of fever, headache, and sore throat. She was found to have (...) bilateral superficial keratitis and treated for suspected early infectious keratitis secondary to extended contact lens wear. She returned the next day with worsening visual symptoms, a new macular rash over her upper torso, and new ulcerating lesions over her buccal and perioral tissue. The patient was diagnosed with SJS. She was successfully treated using systemic cyclosporine with antibiotics and steroid eye drops.Ophthalmologists may be the first physicians to diagnose SJS, a life-threatening

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2018 American journal of ophthalmology case reports

19. Severe Achromobacter xylosoxidans keratitis with deep corneal involvement (PubMed)

Severe Achromobacter xylosoxidans keratitis with deep corneal involvement To describe a case of Achromobacter xylosoxidans keratitis with deep involvement of the corneal stroma and discuss its management.A 73 year-old monocular male with infectious keratitis of the right eye was referred to the Wilmer Eye Institute after a month of empiric treatment with besifloxacin. On presentation, slit lamp examination of the right eye demonstrated a diffusely edematous cornea with three areas of corneal (...) and infiltrates and was referred back to Wilmer. Slit lamp examination again demonstrated an epithelial defect, diffuse corneal haze, deep stromal infiltrates, and a 1 mm hypopyon. Corneal infiltrates were too deep to culture. Ultimately, the patient underwent a therapeutic penetrating keratoplasty with anterior chamber washout resulting in improvement of vision.The indolent progression of A. xylosoxidans keratitis may predispose patients to delayed presentation and treatment. This can result in deep stromal

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2018 American journal of ophthalmology case reports

20. Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea. (PubMed)

Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea. To investigate the risk factors, microbiological profiles, antibiotic susceptibility patterns, and treatment outcome in patients with bacterial keratitis at a Korean tertiary hospital.A retrospective chart review was performed of patients who were diagnosed with infectious keratitis and underwent corneal scrapings for cultures at Seoul National University Hospital between 2007 and 2016 (...) of topical glaucoma medication (p = 0.006) and history of ocular surgery (p = 0.019) were significant risk factors related to evisceration.CNS, Staphylococcus aureus and Pseudomonas aeruginosa were the most common microorganisms responsible for bacterial keratitis. The duo-therapy using vancomycin and ceftazidime should be considered for empirical treatment until the culture and sensitivity results become available.

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2019 PLoS ONE

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