title: Corneal ulcers associated with aerosolized crack cocaine use.
abstract: OBJECTIVE
  We report 4 cases of corneal ulcers associated with drug abuse. The pathogenesis of these ulcers and management of these patients are also reviewed.
  
  
  METHODS
  Review of all cases of corneal ulcers associated with drug abuse seen at our institution from July 2006 to December 2006.
  
  
  RESULTS
  Four patients with corneal ulcers associated with crack cocaine use were reviewed. All corneal ulcers were cultured, and the patients were admitted to the hospital for intensive topical antibiotic treatment. Each patient received comprehensive health care, including medical and substance abuse consultations. Streptococcal organisms were found in 3 cases and Capnocytophaga and Brevibacterium casei in 1 patient. The infections responded to antibiotic treatment. Two patients needed a lateral tarsorrhaphy for persistent epithelial defects.
  
  
  CONCLUSIONS
  Aerosolized crack cocaine use can be associated with the development of corneal ulcers. Drug abuse provides additional challenges for management. Not only treatment of their infections but also the overall poor health of the patients and increased risk of noncompliance need to be addressed. Comprehensive care may provide the patient the opportunity to discontinue their substance abuse, improve their overall health, and prevent future corneal complications.
authors.affiliation: Cornea Service, Wills Eye Institute, Philadelphia, PA, USA.
authors.forename: Faris R
authors.initials: FR
authors.lastname: Ghosheh
authors.forename: Justis P
authors.initials: JP
authors.lastname: Ehlers
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Ayres
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001951:Brevibacterium / Q000302:isolation & purification; D002206:Capnocytophaga / Q000302:isolation & purification; D019970:Cocaine-Related Disorders / Q000150:complications*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016578:Crack Cocaine / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013291:Streptococcus / Q000302:isolation & purification
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents; D016578:Crack Cocaine