Trends in antibiotic resistance in ocular samples in a tertiary eye centre in Saudi Arabia in 2003-2019.

OBJECTIVE: The aim of this study was to analyze the antibiotic resistance in ocular samples over a 16-year period. METHODS: This was a retrospective cohort study conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia (2003-2019). The study included corneal and conjunctival swabs and aqueous and vitreous samples. RESULTS: Coagulase-negative staphylococci exhibited a significant trend of increasing resistance over time to erythromycin (p < 0.001), oxacillin (p < 0.001), fusidic acid (p < 0.001), and moxifloxacin (p = 0.003). Staphylococcus aureus also showed a significant increase in oxacillin (p = 0.001), ofloxacin (p = 0.003), and moxifloxacin (p = 0.001) resistance patterns. Streptococcus pneumoniae demonstrated a significant increase in resistance to erythromycin (p = 0.01) and ofloxacin, which jumped from 0.80% in 2003 to 80% in 2019 (p = 0.015). No statistically significant increase in antibiotic resistance trend was observed for Pseudomonas. CONCLUSIONS: An increasing antibiotic resistance pattern was demonstrated, particularly among gram-positive organisms. Such findings warrant revision of the common ocular antibiotic prescribing strategy and consideration of alternative antibiotics.

Toxic Keratopathy Induced by Self-Application of Seawater.

To report a case of toxic keratopathy secondary to the self-application of seawater eye drops. A 60-year-old male who presented with unexplained unilateral decrease in vision and corneal thinning. Best-corrected visual acuity was 20/400 OD, slit-lamp examination indicated diffuse corneal edema with central thinning, intact sensation, and no vascularization. Laboratory analysis of the eye drops in conjunction with clinical symptoms and findings was consistent with toxic keratopathy. Toxic keratopathy can masquerade as the other forms of keratopathy, and a thorough history taking and laboratory analysis may help elucidate the diagnosis and avoid significant visual morbidity.

Corneal Toxicity after Self-Application of Calotropis procera (Ushaar) Latex: Case Report and Analysis of the Active Components.

Calotropis procera (ushaar) produces a copious amount of latex, which has both inflammatory and anti-inflammatory pharmacological properties. Local application produces an intense inflammatory response and causes significant ocular morbidity. We report corneal toxicity following self-application of latex from C. procera in a 74-year-old man. He reported painless decreased vision in the affected eye with diffuse corneal edema, and specular microscopy revealed a reduced endothelial cell count. After he was treated with topical corticosteroids, his visual acuity improved from hand motion to 20/80. The composition of the active compounds in the latex was analyzed. When topically administered, the latex may cause severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage.