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Microbial Keratitis (microbial + keratitis)
Selected AbstractsBest practice contact lens care: A review of the Asia Pacific Contact Lens Care SummitCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 2 2009Deborah Sweeney BOptom PhD FAAO Contact lens hygiene has long been recognised as key to the prevention of contact-lens associated infection and inflammation. Microbial keratitis (MK) is the only serious and potentially sight-threatening contact lens adverse event. International studies including recent research in Asia Pacific show that MK is rare but, as the consequences can be severe, it is important to minimise the risk factors. Studies continue to show that one of the key risk factors is lens and lens case hygiene. Therefore, it is also useful to review the behaviour of our patients, to see how closely they follow the recommended hygiene practices. Recent studies in various regions have shown that patients' lens care habits do not meet a required standard. Patients can become complacent and thus non-compliant with lens care instructions. Furthermore, they do not understand the high risk of some behaviour and they are not hearing the practitioner when instructions and reminders are given. Further education is important to improve patient compliance and safety. The Asia Pacific Contact Lens Care Summit held in Singapore urged the industry and practitioners to restore the emphasis of proper lens care, including the ,rub and rinse' technique, and developed a new set of guidelines to help eye-care professionals educate their patients on the importance of proper contact lens care to avoid eye infections. The summit also presented the latest research on how to avoid corneal staining, another important element of contact lens care. This review provides a summary of the summit presentations and the science behind these guidelines. [source] Do multipurpose contact lens disinfecting solutions work effectively against non-FDA/ISO recommended strains of bacteria and fungi?OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2010Maureen Boost Abstract Purpose:, Recent outbreaks of microbial keratitis have increased concerns about the efficacy of multipurpose solutions (MPS) against ,real-world' organisms. This study determined, in accordance with FDA/ISO standard methods, the effects of five MPS against clinical isolates and type strains of bacteria, and isolates of fungi from subjects' ocular structures; and of three MPS against environmental fungal isolates. Method:, MPS were challenged with bacteria (type strains (ATCC) and clinical isolates of bacterial pathogens obtained from a district hospital laboratory) and with fungal isolates from both the periocular and conjunctival structures and from environmental air. Results:, All MPS demonstrated at least a 3-log reduction of challenged cell viability of all bacterial species tested, with the exception of MPS D against a canine infection Staphylococcus aureus isolate. Whilst all MPS tested were able to effect a 1.0-log reduction of viability of Fusarium solani (ATCC 36031), only two MPS had 90% viability reduction against all fungi of human origin and only one of these against all environmental fungal isolates. Effectiveness of these two solutions against fungal isolates compared to the remaining three MPS was found to be statistically significant (p = 0.003). Conclusions:, All MPS demonstrated a 99.9% viability reduction against a wide range of bacteria including major ocular pathogens not currently included in the FDA panel. The inability of three MPS to achieve a 90% reduction against fungal isolates is of concern as there has been a recent upsurge in reports of fungal keratitis. We would recommend extension of the current FDA testing panel for MPS to include more fungal isolates. [source] Contact lens induced keratitis associated with contact lens wearACTA OPHTHALMOLOGICA, Issue 5 2001Irene Dejaco-Ruhswurm ABSTRACT. Purpose: To evaluate clinical characteristics, risk factors, management and outcome of contact lens induced keratitis (CLIK) associated with contact lens wear. Methods: The study comprised all consecutive patients presenting with contact lens related presumed microbial keratitis during a 12-month period at our department. Detailed demographic data, type of contact lens, duration of lens wear, wearing schedule and lens hygiene were derived from a self-administered questionnaire. Severity of ulcer, corneal scrapings, treatment and final outcome were evaluated. Results: 27 patients with CLIK, some of which may have been sterile peripheral infiltrates, due to contact lens wear were detected. In the majority of the cases patients had used disposable soft contact lenses (89%) and most of them had a daily wearing schedule (78%). 51.8% patients cleaned their lenses regularly. 6 (22%) applied no disinfection since their lenses were disposable on removal. In 3 of our cases with CLIK, penetrating keratoplasty had to be performed. Conclusion: Disposable contact lenses seem to have been a predisposing factor for contact lens induced keratitis also when used on a daily wear schedule. Insufficient contact lens care products and/or manufacturing characteristics may be responsible for CLIK, which is also observed in otherwise compliant contact lens users. In 3 of our patients with CLIK keratoplasty became necessary, indicating that contact lens induced keratitis may result in severe corneal complications. [source] Who should manage contact lens related microbial keratitis in Australia and New Zealand?CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2008Gerard Sutton FRANZCO No abstract is available for this article. [source] In vivo effects of fluoroquinolones on rabbit corneasCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2003Graeme A Pollock PhD Abstract Purpose: The use of topical fluoroquinolones to treat microbial keratitis is associated with an increased incidence of corneal perforation compared to other standard treatments. This study examined the effects of topical fluoroquinolones on corneal collagen and keratocytes in intact rabbit corneas and corneas with an epithelial defect. Methods: Studies consisted of one group of intact corneas and one group of corneas where a 6-mm epithelial defect was created with a surgical scrape. Within each group, eyes were randomly assigned to one of four topical medications (0.3% ciprofloxacin, 0.3% ofloxacin, fortified antibiotics (1.36% tobramycin, 5% cefrazolin) or Tears Naturale (Alcon Laboratories, Frenchs Forest, NSW, Australia). Two drops were instilled hourly for 48 h and then 2-hourly for an additional 48 h. At 96 h the corneas were removed and processed for light microscopy, immunohistology for collagen IV, V and VI, and apoptosis staining. Results: In intact rabbit corneas there was no demonstrable difference between treatment groups. In corneas with an epithelial defect, both fluoroquinolones delayed epithelial healing when compared to fortified antibiotics or tears. Keratocyte loss was seen in all groups and was greatest in the ofloxacin group. Median stromal thickness with keratocyte loss were: ofloxacin 30%; ciprofloxacin 10%; fortified antibiotics 7.5%; and tears 15% (ofloxacin vs tears, Mann,Whitney = 16.0, P = 0.09). Keratocyte loss did not correlate with the amount of demonstrable apoptosis. Collagens IV, V and VI showed no differences between treatments. Conclusions: These results suggest that ofloxacin is potentially cytotoxic to corneal keratocytes. Such an effect could lead to the observed increased incidence of corneal perforation in microbial keratitis. [source] Which is more important to the initiation of contact lens related microbial keratitis, trauma to the ocular surface or bacterial pathogenic factors?CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 5 2006Mark DP Willcox BSc (Hons) PhD No abstract is available for this article. [source] | ||||||||||