When a causative organism is not identified in microbial keratitis, visual acuity is not as severely affected, and fewer severe complications occur. Antibiotic resistance to fluoroquinolones and aminoglycosides, though not common, still deserves consideration in the treatment of microbial keratitis.

Sutureless and adhesiveless amniotic membrane transplantation is a safe and effective method to promote healing and reconstruction of the ocular surface and orbit with minimal side effects. Recurrence of the underlying primary pathology remains a concern. The advent of a newer, softer conformer ring may improve patient tolerability and limit discomfort.

We previously published a 5-year review of 132 cases of microbial keratitis at a major urban county hospital. 1 In 73 (55.3%) cases a causative organism was identified by either culture or confocal microscopy. At least one risk factor was present in 115 (87.1%) patients, including 35 (26.5%) patients with a history of contact lens wear. Contact lens wear was the second most common risk factor following preexisting ocular disease.We would like to further describe the characteristics of this group of 35 eyes with contact lens-related corneal ulcers. Twentyone (60%) of these patients had nonsterile microbial keratitis. In the culture-positive group, Pseudomonas aeruginosa was the most common culprit organism (52.3%), which correlates with prior epidemiologic studies of contact-lens related microbial keratitis. 2,3 Other causative organisms isolated in our study included Staphylococcus aureus (3), Acanthamoeba (3), Serratia marcescens (2), non-pneumococcus streptococcal species (1), and Propionibacterium sp (1). All of the isolates in this group tested for antibiotic susceptibilities were found to be sensitive to fluoroquinolones (ciprofloxacin and/or levofloxacin) and aminoglycosides (tobramycin and/or gentamicin).