Childhood microbial keratitis

To evaluate risk factors for pediatric microbial keratitis and to describe the clinical picture, microbial spectrum, treatment modalities, posttreatment sequelae, and visual outcome in cases with pediatric microbial keratitis. All cases of microbial keratitis that occurred in children 16 years or younger who had an initial examination between January 2000 and December 2010 at a tertiary referral eye hospital in Riyadh, Saudi Arabia, were identified. A retrospective review of medical records was conducted using a computer-based diagnosis code. Demographic data, predisposing factors, clinical course, microbial culture results, and visual outcomes were recorded. Sixty-eight eyes were included in this study. Predisposing factors were identified in 63 eyes [92.6%]. All patients had unilateral microbial keratitis. The mean +/- SD age was 4.5 +/- 4.8 years and 57.4% were male. Trauma was the leading cause [27 eyes [39.7%]], followed by systemic diseases [14 eyes [20.6%]], contact lens wear [11 eyes [16.1%]], and ocular diseases [11 eyes [16.1%]]. Corneal scraping was performed in all cases. Five patients needed general anesthesia to carry out the corneal scraping. Thirty-four [50.0%] eyes showed positive cultures. Gram-positive bacteria accounted for 67.8% and gram-negative bacteria for 38.2% of isolates. Streptococcus pneumoniae was the most commonly isolated organism [8 eyes [25.8%]], followed by Staphylococcus epidermidis [7 eyes [22.7%]]. Pseudomonas aeruginosa was the most commonly isolated gram-negative [6 eyes [17.6%]] organism. One eye had corneal perforation and required surgical intervention. Forty-five of 68 eyes [66.2%] had a best-corrected visual acuity evaluation at the last follow-up and 28 eyes [62.2%] of them had a best-corrected visual acuity of 20/40 or better. Children with suspected microbial keratitis require comprehensive evaluation and management. Early recognition, identifying the predisposing factors and etiological microbial organisms, and instituting appropriate treatment measures have a crucial role in outcome. Ocular trauma was the leading cause of childhood microbial keratitis in our study

Non-viral microbial keratitis in children

Microbial [non-viral] keratitis is a serious vision-threatening condition. The management of microbial keratitis in children is particularly complicated by the children's inability to cooperate during examinations and the lack of information prior to presentation. Predisposing factors vary according to geographical location and age. Corneal trauma is the leading cause for microbial keratitis in children, followed by systemic and ocular disease. Etiologic agents are most frequently Gram-positive and Gram-negative bacteria commonly found in contact lens-related microbial keratitis. Mycotic keratitis is a major risk factor in tropical weather conditions, particularly when associated with agricultural trauma. Early diagnosis, intensive drug treatment, and timely planned surgical intervention may effectively improve the outcome of pediatric microbial keratitis

Polymethyl methacrylate intraocular lens opacification 20 years after cataract surgery: a case report in a tertiary eye hospital in Saudi Arabia

Snowflake degeneration is a slow progressive opacification of polymethyl methacrylate [PMMA] intraocular lenses [IOLs]. This late postoperative complication can occur a decade or later after implantation. The deposits are composed of IOL materials that tend to aggregate centrally. There is a relative paucity of the literature on snowflake degeneration of IOLs. Symptoms can range from mild visual disturbance to significant loss of visual acuity. In cases of opacification after IOL implantation, the different diagnosis should include snowflake degeneration to prevent surgical intervention such as lens exchange or explantation unless clinically warranted. We report a case of late optical opacification of a PMMA IOL, the clinical diagnosis and treatment that increased best corrected vision

Long term visual outcomes in laser treated threshold retinopathy of prematurity in Central Saudi Arabia

To assess the long term visual outcomes and refractive status of patients who underwent diode laser for threshold retinopathy of prematurity [ROP] and to investigate the risk factors leading to poor visual outcomes. Fifty-seven patients [114 eyes] with threshold ROP who underwent laser therapy were contacted for reassessment. A chart review was performed for all patients to collect data on visual acuity, retinal status and strabismus. A favorable visual outcome was defined as <20/160 [Snellen acuity] for young adults [cooperative patients], and CSM for children [uncooperative patients] while unfavorable visual outcome was defined as <20/160 or