{"id":24,"url":"https://cclm.media-doc.io/conditions/24/","name":"Microbial Keratitis","category":"Cornea","detail":"<p>Corneal ulcer, infectious keratitis, ulcerative keratitis, corneal infection</p>\n\n<h2>Symptoms</h2>\n\n<ul>\n\t<li>Acute severe pain</li>\n\t<li>Extreme redness &ndash; usually all quadrants</li>\n\t<li>Epiphora and photophobia</li>\n\t<li>No improvement with lens removal</li>\n</ul>\n\n<h2>Signs</h2>\n\n<ul>\n\t<li>Localized corneal excavation, penetrating into the stroma, with underlying infiltrate and surrounded by edema</li>\n\t<li>Generally central or paracentral, large (&gt;1mm), irregular appearance</li>\n\t<li>Typically unilateral</li>\n\t<li>Severe hyperemia and possibly lid edema.</li>\n\t<li>Mucopurulent or watery discharge, aqueous flare often present</li>\n\t<li><a href=\"/condition/2\">Also see&nbsp;Acanthamoeba&nbsp;Infection</a></li>\n</ul>\n\n<h2>Etiology</h2>\n\n<ul>\n\t<li>Infection with epithelial disruption</li>\n\t<li>Most virulent pathogens are&nbsp;<em>Pseudomonas aeruginosa</em>&nbsp;and&nbsp;<em>Acanthamoeba</em></li>\n</ul>\n\n<h2>Prevalence</h2>\n\n<ul>\n\t<li>Rare</li>\n\t<li>Higher prevalence in EW of soft lenses</li>\n</ul>\n\n<h2>Differential Diagnosis</h2>\n\n<ul>\n\t<li><a href=\"/condition/20\">Corneal Infiltrates</a> ,<a href=\"/condition/6\">CLPU</a> &nbsp;and other staining patterns</li>\n\t<li><a href=\"/condition/66\">See: Infiltrates and Opacities &ndash; Differential Diagnosis</a></li>\n</ul>\n\n<h2>Management</h2>\n\n<ul>\n\t<li>Cease lens wear immediately</li>\n\t<li>Consider culturing before initiating antibiotic therapy, particularly for large central ulcers</li>\n\t<li>Instigate topical antibiotic treatment immediately. Follow up daily until resolved</li>\n\t<li>Replace all lenses and lens care products including lens case before recommencing lens wear</li>\n\t<li>Further lens wear should be restricted and be undertaken cautiously</li>\n\t<li>Further EW inadvisable and may recommend DW</li>\n</ul>","images":[{"name":"Microbial Keratitis","file":"https://cclm-static.s3.amazonaws.com/images/microbial-keratitis-01_zoom.jpg"},{"name":"Microbial Keratitis","file":"https://cclm-static.s3.amazonaws.com/images/microbial-keratitis-02_zoom.jpg"}],"type":1,"videos":[{"name":"Microbial Keratitis Microbial Keratitis - Central with Hypopyon","videoSrc":"248362131"}],"wear":false,"ceaseWear":true,"changeLens":false,"changeSolutions":false,"changeCare":false,"counseling":false,"dd":false,"dw":false,"gp":false,"replace":false,"review":true,"rewettingDrops":false,"rx":true,"SiHy":false,"toric":false,"tags":[]}