Infectious keratitis.
OBJECTIVE
Infectious keratitis is a medical emergency. Improper management can lead to marked loss of vision. This review identifies recent trends in the study of infectious keratitis.


RESULTS
A multicountry outbreak of Fusarium keratitis emphasizes that contact lens wear is a major risk factor for infectious keratitis. Acanthamoeba and fungal keratitis are the most expensive forms of infectious keratitis to treat. Noninvasive methods and molecular techniques have improved diagnosis of infectious keratitis. Fortified topical antibiotics and fluoroquinolones are still the mainstay of bacterial keratitis therapy. Voriconazole and new routes of administration of conventional antifungals appear promising for fungal keratitis. Antivirals and amelioration of host inflammatory response are promising for viral keratitis; the host response is also crucial in pathogenesis of Pseudomonas aeruginosa keratitis. Trauma-induced bacterial and fungal keratitis and contact lens-associated keratitis are preventable entities.


CONCLUSIONS
Improved modalities of diagnosis and treatment have improved the outcome of infectious keratitis, but therapy of acanthamoebal, fungal and P. aeruginosa keratitis is still a challenge. Effective strategies must neutralize potential risk factors and counter host response overactivity without impairing killing of infecting microorganisms. Trauma-induced bacterial and fungal keratitis can be prevented.
Thomas
Philip Aloysius
PA
Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli, India. philipthomas@satyam.net.in
Geraldine
Pitchairaj
P
D000048:Acanthamoeba / Q000187:drug effects / Q000472:pathogenicity; D000562:Amebiasis / Q000188:drug therapy; D000818:Animals; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000503:physiopathology*; D015828:Eye Infections, Viral / Q000503:physiopathology / Q000821:virology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D008297:Male