ABSTRACT
PURPOSE: : To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus. METHOD: : Case report. RESULT: : A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings. CONCLUSIONS: : Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
Subject(s)
Contact Lenses/adverse effects , Corneal Ulcer/microbiology , Eye Infections, Bacterial/microbiology , Photochemotherapy/adverse effects , Staphylococcal Infections/microbiology , Streptococcal Infections/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Collagen/metabolism , Corneal Ulcer/diagnosis , Corneal Ulcer/drug therapy , Drug Therapy, Combination , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Humans , Keratoconus/drug therapy , Keratoconus/metabolism , Male , Photosensitizing Agents/therapeutic use , Riboflavin/therapeutic use , Risk Factors , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus/isolation & purification , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Streptococcus oralis/isolation & purification , Ultraviolet Rays , Visual AcuityABSTRACT
Objective: To determine the patient profile and risk factors for badminton-related eye injuries in Metro Manila. Methods: We conducted a cross-sectional survey of badminton-related eye injuries in Metro Manila. A survey form was sent to 13 ophthalmologists who were asked to report on patients treated for badminton-related eye injuries from July 1 to December 1, 2004. The following data were collected: patient age, gender, and sports experience; details of eye injury; use of protective eyewear; and visual outcomes. Logistic regression analysis was performed to predict sight-threatening injuries. Results: The average patient age was 34.7 +/- 6.2 years (range 18 to 46). There were more males than females (1.55:1). All patients sustained eye injury while playing doubles. None of the patients were wearing protective eyewear at the time of injury. Blunt trauma due to shuttlecock impact was the cause of injury in 74 % of cases. The most common ocular findings were iridocyclitis (n = 11), secondary glaucoma (n = 6), and hyphema (n = 5). Twenty-nine sight-threatening conditions were reported. Six (26 %) patients developed chronic ocular sequelae. Conclusion: Sight-threatening injuries can occur in individuals playing badminton. While vision loss is uncommon, treatment outcomes are generally good. Since all injuries were sustained without the use of protective eyewear, ophthalmologists have a responsibility to promote its use when playing badminton.
