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2003
OMIG, Abstract 7
OMIG
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Psedomonas
Radial Keratoneuritis
Juliana F Freitas, Stephanie A Baxter, Christopher J Rapuano, Peter
R Laibson, Elisabeth J Cohen
Purpose:
We will describe three cases of radial keratoneuritis associated
with Pseudomonas corneal ulcers.
Methods: Retrospective, case series.
Results: Three patients with acute, central, purulent,
corneal ulcers were referred to Wills Eye Hospital. All patients
were soft contact lens wearers. Corneal scrapings were performed
in all cases. Each patient received intensive, initial treatment
with topical fortified tobramycin (50mg/ml) and cefazolin (15mg/ml).
Two of the three cultures grew Pseudomonas. The third case was suspected
to be Pseudomonas, given its clinical appearance. A radial keratoneuritis
developed in all patients three to five days after their presentation
to our center.
Discussion: Radial keratoneuritis has traditionally
been felt to be pathognomonic for Acanthamoeba keratitis. We report
three cases of radial keratoneuritis not associated with Acanthamoeba.
Although both Pseudomonas and Acanthamoeba can occur in contact
lens wearer and cause a radial keratoneuritis, they can often be
distinguished clinically: Pseudomonas related corneal ulcers have
a rapid onset and tend to be associated with adherent mucopurulent
discharge. Thus, acute keratitis in contact lens wearers should
be suspected and treated as Pseudomonas ulcers, even if they should
develop radial keratoneuritis early in their course.
OMIG
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