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How to diagnose and treat Acanthamoeba keratitis

Corneal ulceration caused by Acanthamoeba is on the rise, and recent publications indicate an outbreak in the UK over the last few years [1]. Since Acanthamoeba keratitis often presents with atypical features, diagnosis from slit-lamp examination alone can often be...

Does Acanthamoeba need bacteria to cause keratitis?

An animal study was carried out on 36 rabbits, whose corneas were inoculated with either Acanthamoeba castellanii alone, Pseudomonas aeruginosa alone or both pathogens together after a period of short (two hours) or long (six hours) co-incubation. The clinical severity...

Bacterial keratitis through the window of the known unknowns

This review article provides an up-to-date summary of current challenges in research and management of bacterial keratitis. The authors highlight that there is no current agreement on the criteria that should define bacterial keratitis; the role of investigation is unclear,...

Adjuvant oral voriconazole or oral ketoconazole for fungal keratitis

This randomised double-blinded trial examined clinical outcomes of 50 patients with severe fungal keratitis treated with either adjuvant oral voriconazole or oral ketoconazole. Inclusion criteria were culture or smear proven fungal ulcers >5mm in maximum diameter, involving >4mm of the...

DALK as an early therapeutic option for Acanthamoeba keratitis

Eleven patients with Acanthamoeba keratitis (AK) were treated by early therapeutic deep anterior lamellar keratoplasty (DALK). All surgeries were performed in patients who had no response to standard medical therapy of chlorhexidine gluconate, propamidine isethionate and neomycin sulphate, within 10-15...

Non-contact-lens-associated acanthamoeba keratitis

This retrospective study was done to study the clinical presentation and microbiological results of non-contact-lens-related acanthamoeba keratitis (AK). One hundred and ninety-four patients with microbiological / histopathological diagnosis of AK over four years were included. All patients had corneal scrapings...

New solutions in the prevention and treatment of Acanthamoeba keratitis

The global increase in Acanthamoeba keratitis infections has emphasised the inefficiencies of current treatment and preventative methods, here researchers from the West of Scotland detail a promising new series of compounds that may stem the tide. News headlines detailing horror...

Multidrug-resistant keratitis: challenging yet manageable

This is a retrospective review of all patients’ records from a tertiary referral centre in India from January 2018 to December 2019, who had corneal scrapings for direct smear and culture sensitivity. Those cases where the organisms were diagnosed to...

Microsporidia-induced stromal keratitis: a new cause of presumed immune stromal (interstitial) keratitis

This is a non-comparative retrospective observational case series from India from 1 October 2020 to 31 January 2021. The inclusion criteria were: (1) presence of nummular / coin shaped lesions with at least one >2mm in size and / presence...

Do topical steroids improve visual outcome in the treatment of bacterial keratitis?

The use of topical corticosteroids as an adjunctive treatment to antibiotics in the management of bacterial keratitis remains a controversial issue. The results of the Steroids for Corneal Ulcers Trial (SCUT) – a randomised, double-masked, placebo-controlled trial that recruited patients...

Microbiology, risk factors and outcomes of microbial keratitis in Sydney, Australia

The authors present a retrospective case series including all patients with microbial keratitis and ocular surface diseases (OSD), including dry eye, blepharitis, Stevens-Johnson syndrome and / or ocular cicatricial pemphigoid, over a five-year period between 2012 and 2016. A total...

γδ T cell depletion does not affect fungal keratitis

Fungal keratitis (FK) is a blinding condition prevalent in agricultural areas of countries such as India and China. The fungus enters the cornea and induces an inflammatory response which leads to tissue damage. Neutrophils are the earliest infiltrating immune cells...