title: Bilateral nocardia keratitis after photorefractive keratectomy.
abstract: OBJECTIVE
  To report the clinical, confocal scan, and histopathologic features of nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK).
  
  
  METHODS
  A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis.
  
  
  CONCLUSIONS
  Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response.
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Faramarzi
authors.forename: Sepehr
authors.initials: S
authors.lastname: Feizi
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Javadi
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Rezaei Kanavi
authors.forename: Forouzan
authors.initials: F
authors.lastname: Yazdizadeh
authors.forename: Hamid-Reza
authors.initials: HR
authors.lastname: Moein
keywords: Confocal Scan; Nocardia Keratitis; Photorefractive Keratectomy