title: Bilateral simultaneous infective keratitis.
abstract: OBJECTIVE
  To analyze the demographics, risk factors, clinical and microbiological characteristics of cases of bilateral simultaneous infective keratitis.
  
  
  METHODS
  In this retrospective case series, patients with clinical evidence of bilateral simultaneous infective keratitis were identified from January 1, 2011 to August 31, 2016. Demographics, risk factors, clinical and microbiological characteristics, and treatment outcomes were analyzed.
  
  
  RESULTS
  Five patients (ten eyes) with bilateral simultaneous infective keratitis were identified. The mean age was 32.8 years (SD,±8.8; range, 24-44). All the patients were disposable soft contact lens wearers before presentation. The average size of the infiltrate was 4.76mm2(SD±9.0; range, 0.2-31.34). A total of 4 types of bacteria were isolated, with Pseudomonas aeruginosa being the most frequently isolated bacteria involving 5 eyes of four patients. Infection resolved with medical treatment in 9 eyes, 1 patient required therapeutic corneal transplantation for impending corneal perforation. The average time taken for infection to resolve was 6.7days (SD±4.5; range, 2-16).
  
  
  CONCLUSIONS
  In this case series, the most common risk factor of bilateral simultaneous microbial keratitis was use of soft disposable contact lens and the most commonly isolated bacteria was Pseudomonas aeruginosa. Bilateral simultaneous infective keratitis is uncommon and is a serious complication of contact lens use in immunocompetent adult patients.
authors.affiliation: Department of Ophthalmology, National University Hospital, Singapore.
authors.forename: Lai Hiu
authors.initials: LH
authors.lastname: On Annie
authors.affiliation: Department of Ophthalmology, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: mantoshr@yahoo.com.
authors.forename: Manotosh
authors.initials: M
authors.lastname: Ray
mesh_terms: D000328:Adult; D003261:Contact Lenses / Q000382:microbiology*; D003315:Cornea / Q000382:microbiology* / Q000473:pathology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D055815:Young Adult
keywords: Bilateral; Infective; Keratitis