Corneal infections still keep me awake at night and I am sure I am not alone.
While most infections can be successfully treated using a topical antibiotic and close monitoring, some require culturing for pathogen identification and treatment specificity. Standard culturing techniques remain the standard of care but new techniques allow for faster identification.
Lesions located in the center of the cornea, involving the deeper stromal layers, or are large (> 2 mm) should be cultured to reduce the risk of vision loss. Risk increases with a history of contact lens over-wear or use of contaminated solutions, immunocompromised states (such as HIV or active chemotherapy), exposure to lakes, swimming pools, or hot tubs prior to infection, or vegetative material in the eye. Ulcers with feathery edges, opaque or gray color, severe anterior chamber reactions, multiple (satellite) lesions, or those associated with descemetocele should be considered highly suspicious. Culturing identifies pathogens as bacterial (Gram-positive, negative), fungal, parasitic, and viral, and aids in specific treatment.
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