title: Microbial keratitis in patients with down syndrome: a retrospective study.
abstract: OBJECTIVE
  To study the microbiological and clinical profile of cases of microbial keratitis in patients with Down syndrome.
  
  
  METHODS
  A retrospective chart review of all patients with Down syndrome and microbial keratitis admitted to the Royal Victorian Eye and Ear Hospital, Melbourne, Australia, between January 1997 and January 2007 was undertaken. Main parameters evaluated were clinical and microbiological profile and final outcome.
  
  
  RESULTS
  Of 18 patients included in this study, 11 were men and 7 were women, with mean age of 50 +/- 29 years (range 20-61 years). The most common associated ocular abnormality was eyelid diseases (94%) followed by atopic keratoconjunctivitis (44%). Positive microbiological cultures were obtained in 5 (28%) cases with Streptococcus pneumoniae being the most prevalent isolate. Ocular herpes was detected in 2 patients with polymerase chain reaction. Surgical intervention was required in 13 (72%) patients in the form of keratoplasty (n = 3) corneal gluing (n = 2), tarsorrhaphy (n = 5), botox injection (n = 1), and enucleation (n = 2).
  
  
  CONCLUSIONS
  Microbial keratitis in Down syndrome is associated with eyelid problems and ocular atopy, and due to failure of medical therapy alone, surgical intervention is required in majority of cases.
authors.affiliation: Royal Victorian Eye and Ear Hospital; and Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Sonia
authors.initials: S
authors.lastname: Moorthy
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000269:Adhesives / Q000627:therapeutic use; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D016039:Corneal Transplantation; D004314:Down Syndrome / Q000150:complications*; D015353:Eye Enucleation; D005141:Eyelid Diseases / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D007267:Injections; D007634:Keratitis / Q000150:complications* / Q000382:microbiology* / Q000628:therapy; D016849:Keratitis, Herpetic / Q000150:complications; D007637:Keratoconjunctivitis / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D011008:Pneumococcal Infections; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae; D055815:Young Adult
chemical_list: D000269:Adhesives; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A