Bacteria that can invade intact cornea

Demodex folliculorum: a. F It is a demodectic mite and may be implicated in blepharitis. It is not visible with slit-lamp. Its presence increases with age. The presence of translucent cylinders resembling clear plastic insulation or cuffs enclosing the base of a lash for a distance of about 1 mm is suggestive of the presence of Demodex in the follicle.

Treatment is difficult. More MCQs. The optometrists play a key role in the preliminary diagnosis and referral of these patients to cornea and external disease specialists. The nursing team also plays an instrumental role in counseling these patients regarding contact lens hygiene, use, frequency, educating the patients regarding signs and symptoms of bacterial keratitis.

The nursing team also guides these patients regarding the frequency and dose of antibacterials to be used at home. The pharmacists also help in procuring the drugs for these patients. Hence, in a nutshell, the interprofessional teamwork of all paramedical staff and the treating ophthalmologists determines the functional and anatomical in these patients.

If treated in a timely fashion, bacterial keratitis patients can have good outcomes, which is a benefit for any patient for their day-to-day living. Sultan Qaboos University medical journal. A study of cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis. Australian and New Zealand journal of ophthalmology. Morbidity and mortality weekly report. Indian journal of ophthalmology.

Survey of ophthalmology. Clinical microbiology reviews. Clinical optometry. American journal of ophthalmology. The British journal of ophthalmology. An electron microscopic study. Ophthalmic epidemiology. Lancet London, England. A multivariate analysis.

A three-year prospective study in Gothenburg. Acta ophthalmologica. The New England journal of medicine. La Clinica terapeutica. Seminars in ophthalmology. JAMA ophthalmology. Romanian journal of ophthalmology. Middle East African journal of ophthalmology. Equine veterinary journal. Rohatgi JN, Bacteriology of corneal ulcer with special reference to hypopyon corneal ulcer.

Journal of the All-India Ophthalmological Society. Journal of clinical microbiology. Podschun R,Ullmann U, Klebsiella spp.

Journal of medical microbiology. Journal of ophthalmic inflammation and infection. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. Leck A, Taking a corneal scrape and making a diagnosis. Community eye health. New microbes and new infections. The New Zealand medical journal. Archives of ophthalmology Chicago, Ill. Oman journal of ophthalmology. Journal of ophthalmology.

Gokhale NS, Medical management approach to infectious keratitis. Daniell M, Overview: Initial antimicrobial therapy for microbial keratitis. Experimental and therapeutic medicine. European journal of ophthalmology.

Journal of glaucoma. Gurnani B,Kaur K, Rare traumatic anterior dislocation of capsular tension ring-intraocular lens complex in-toto. Gurnani B,Kaur K,Gireesh P, A rare presentation of anterior dislocation of calcified capsular bag in a spontaneously absorbed cataractous eye. Gurnani B,Kaur K,Sekaran S, First case of coloboma, lens neovascularization, traumatic cataract, and retinal detachment in a young Asian female.

Clinical case reports. Journal of pediatric ophthalmology and strabismus. Bacterial Keratitis. Continuing Education Activity Bacterial keratitis or corneal ulcer is a common sight-threatening ocular corneal pathology. Introduction Bacterial keratitis or corneal ulcer is an infection of the corneal tissue caused by varied bacterial species. Gram-negative coccobacillus include Haemophilus influenza and Haemophilus aegyptius Gram-positive filamentous bacteria include Nocardia asteroids and Nocardia brasiliensis Coagulase-negative Staphylococcus is one of the most common bacterial species identified recently The most common species causing bacterial keratitis include Staphylococcus aureus , Staphylococcus epidermidis , Streptococcus pneumoniae , Pseudomonas aeuruginosa , and species of the Enterobacteriaceae family.

Klebsiella It is rare keratitis often associated with chronic epithelial disease, and Klebsiella pneumoniae had also been reported in patients using contact lenses. Chronic and unresponsive keratitis to broad-spectrum antibiotics Previous history of corneal surgery. Atypical clinical features Significant multiple infiltrates in different locations of the cornea. Various Strains Used for Bacteria Gram stain - gram-positive bacteria appear purple and gram-negative as pink.

Newer Diagnostic Modalities Immunohistochemistry, enzyme immunoassay, polymerase chain reaction, and radioimmunoassay are recent upcoming modalities but still have a limited role in diagnosing bacterial keratitis. Aminoglycosides Fortified topical tobramycin 0. Fluoroquinolones The drugs available are 0. Antiglaucoma Drugs Antiglaucoma drugs are a useful adjunctive modality for controlling intraocular pressure. Lubricating Eye Drops These drugs help epithelial healing, reduce irritation, wash away debris and necrotic enzymes, and smoothen the ocular surface and cornea.

Systemic Anti-inflammatory Drugs These drugs help to reduce pain and inflammation. Protective Measures Besides the targeted therapy, equally, importance must be given to protective measures like using dark goggles, preventing direct exposure to sunlight, excessive eye rubbing, applying soap or direct water splash in the eyes, rest, good and timely diet, and hot fomentation. Surgical Treatment Gunderson Flap This treatment is beneficial when a donor cornea is not available to salvage a perforated corneal ulcer.

Complications Corneal scarring Corneal melt Corneal anesthesia Neurotrophic keratopathy Descemetocele Perforation Secondary glaucoma Neovascular glaucoma [56] Iris Neovascularization Hyphema Hemorrhage Toxic iridocyclitis Subluxation of lens [57] [58] Anterior subcapsular cataract [59] [60] Corneal fistula Scleritis Retinal detachment Choroidal detachment Endophthalmitis Panophthalmitis Keratectasia Atrophic bulbi Autoevisceration Phthisis bulbi Surgical Complications Wound leak Irregular trephination Small size graft Secondary glaucoma Flat anterior chamber Iridodialysis Pupillary block Expulsive choroidal hemorrhage Retinal detachment Choroidal detachment Vitreous hemorrhage Suture Related Complications Vascularization Infection Loose sutures Wound leak Exposed knots Postoperative and Rehabilitation Care Counseling and regular follow-up are important for a good postoperative outcome.

Consultations Any patient with bacterial keratitis presenting to the emergency ophthalmology outpatient department must be evaluated carefully with a high index of clinical suspicion. Deterrence and Patient Education Based on their clinical presentation, all patients with bacterial keratitis must receive education regarding the pathology and the long-term prognosis. Pearls and Other Issues So, in a nutshell, bacterial keratitis is a disease prevalent in the underdeveloped and developing worlds.

Enhancing Healthcare Team Outcomes Bacterial keratitis is a significant cause of vision-threatening keratitis across the globe. Click Image to Enlarge Slit lamp image depicting conjunctival congestion, 5x5 mm epithelial defect, mid stromal infiltrate with corneal thinning post bacterial keratitis Contributed by Dr. Click Image to Enlarge Slit lamp image depicting meibomian gland dysfunction, conjunctival congestion, total corneal melt, corneal perforation and anterior staphyloma formation suggestive of perforated corneal ulcer post pseudomonas keratitis Contributed by Dr.

Click Image to Enlarge Slit lamp image depicting diffuse conjunctival congestion, 2x2 mm circular anterior stromal corneal infiltrate, stromal edema, cellular reaction along with 2 mm hypopyon suggestive of bacterial keratitis post foreign body injury Contributed by Dr.

Feedback: Send Us Your Comments. Yes these are the pathogenic bacteria which cause invasion of normal corneal epithelium. Among the list it is B corynbacteria But other are Neisseria gonorrhea. Meningitis and listeria species. View 1 other reply. Paracetamol poisoning- :- - acetyl cysteine 2.

MRSA :- vancomycin OCD :- fluoxetine Malaria in Pregnancy-Chloroquine Whooping Cough or Perteusis- Erythromycin Kawasaki disease-IV Ig Warferin Overdose-Vit-K Heparin Overdose-Protamine Hairy Cell Leukemia-Cladirabine Multiple Myeloma- Melphalan CML-Imatinib Wegner's granulomatosis-Cyclophosphamide HOCM- Propranolol Delirium Tremens-Diazepam Test Ocular microbiology.

Bacteria that can invade intact corneal epithelium include: a. Pseudomonas aeurginosa b. Neisseria gonorrhoea c. Haemophilus influenzae d.