Bacterial keratitis

Bacterial keratitis is also often referred to as a corneal ulcer, although these terms are not directly interchangeable because a cornea may harbor a bacterial infection (i.e bacterial keratitis) without having a loss of tissue (an ulcer), and a cornea may have an ulcer without a bacterial infection.

Background

Clinical Features

Bacterial keratitis due to Pseudomonas spp.
  • Blurred vision
  • Severe pain and photophobia
  • Perilimbic injection
  • Normal pupil size
  • Eyelid edema
  • Mucopurulent exudate
  • Posterior synechiae (iris adheres to cornea)

Differential Diagnosis


Evaluation

  • Topical anesthesia with proparacaine, as opposed to tetracaine which has bacteriostatic effects, limiting culture results
  • Culture and gram stain of corneal ulcer edges, eyelids, conjunctiva, contact lenses
  • Ultrasound to assess for signs of endophthalmitis and other pathologies

Management

Disposition

  • Ophtho consult for possible perforation risk
  • Eye patch in the interim

See Also

References