Infective Keratitis is a commonly encountered sight-threatening ocular emergency. In developing countries, it is a major cause of corneal blindness. Empirical treatment without microbiological work up often leads to treatment failure. Indiscriminate use of steroid antibiotic combination worsens the situation and makes further management challenging. The correct line of management can be potentially sight saving for both the ophthalmologist and the patient. This article on Infective keratitis has been written keeping best practices and protocols in mind. In a very simple and concise form, it focuses on the salient features of clinical presentation of infective keratitis and the stepwise approach to subsequent management in a patient. It explains in detail the way to perform corneal scraping, the importance of the same and further management based on microbiologically proven result. The management part includes indications and methods for medical as well as surgical intervention. We aimed to share our experience in the management of patients presenting with infective keratitis in the clinic.

Intraocular pressure measurement in a case of ulcerative microbial keratitis is often neglected as treatment of ulcer takes precedence. However, prolonged rise in IOP can cause optic nerve damage and failure of visual recovery even after complete resolution of keratitis. This prospective longitudinal comparative study was done to evaluate the importance of IOP measurement in cases of ulcerative keratitis.Methods: 122 cases of ulcerative microbial keratitis were divided into three groups based on their etiology-bacterial (Group A), fungal (Group B) and indeterminate (Group C). Comparative evaluation of IOP between all the three groups was done and results recorded.Results: On presentation, IOP was significantly high in bacterial and indeterminate group (Group A and C) but subsequently responded to treatment. In fungal keratitis, higher IOP was noted later in the follow up visits. The IOP was also related to the size of ulcer and depth of infiltrate with size more than 5 mm and midstromal level of infiltrate showing a significantly high IOP. Conclusion:IOP measurement and management although difficult in cases of keratitis if neglected can cause permanent loss of vision.

No abstract

Background: Previous published literature has shown that there is no significant difference between outcomes of culture positive and culture negative infective keratitis. This study was done to find the outcome in cases of indeterminate keratitis in our institute. Purpose was to highlight the fate of indeterminate microbial keratitis.Methods: Patients presenting to cornea services of ABVIMS and Dr. RML hospital from February 2017 to April 2021 were evaluated for demographic and microbiological assessment, clinical presentation and management.Results: The 188 out of 310 cases were microbiologically positive. No organism could be detected in 122 cases. Clinical prognosis is worse in cases of indeterminate keratitis.Conclusions: Cases with indeterminate microbial keratitis do not show timely and appropriate response which leads to spread of infection resulting in more complications and less CDVA.

No abstract