Posterior keratoconus due to iron nail injury--a case report.

A case of post-traumatic keratoconus is presented. This is an unusual variant of an uncommon disorder. Posterior keratoconus is a very rare ectatic dystrophy of the cornea. Since its first description in 1927, only a few cases have been described in the literature. Posttraumatic posterior keratoconus is a much rarer entity. We are reporting a case of posterior keratoconus caused by iron nail injury.

Ocular atopy and mycotic keratitis.

In a retrospective analysis, we studied the association between ocular atopy and keratomycosis. Forty-one (26.3%) of 156 patients with fungal corneal ulcers were found to have preexisting allergic conjunctivitis. All patients had been using a combination of antibiotics and corticosteroids before developing the corneal ulcer. Fungus isolation on Sabouraud's agar medium was obtained in 74.8% (31/42) ulcers. The most common fungi isolated were Fusarium (32.3%) and Aspergillus (29%). One percent silver sulfadiazine was used as an antifungal agent in these patients. Overall efficacy of this drug was found to be 77.8%, with Fusarium being the most sensitive (87.5%).

Clinicobacteriological correlates of congenital dacryocystitis.

One hundred and fourteen eyes with congenital dacryocystitis have been studied clinically and bacteriologically. Gram positive cocci constituted the major bacterial isolates (57.9%) with streptococcus pneumoniae predominating (28.9%). The most effective antibiotic was cloxacillin with an overall efficacy of 77%. Normal conjunctival flora was sterile in majority (75%) of cases. Positive cases showed preponderance of gram positive cocci (21.6%) with staphylococcus albus (13.3%) being the major isolate. Normal nasal flora revealed diphtheroids (alone or in combination) to be the commonest bacteria (62.1%). A statistically significant correlation was not observed between the normal conjunctival or nasal flora and flora from the affected eyes.

Study of an outbreak of epidemic conjunctivitis in Delhi in 1986.

An epidemic of acute conjunctivitis occurred in Delhi during July-September 1986. The clinical presentation in total of 350 patients were characteristic of acute haemorrhagic conjunctivitis (AHC). Bacterial cultures from conjunctival swabs were sterile in 85 out of 105 (80%) patients, virus cultures in Vero and HeLa cells were negative in 30 patients. However, conjunctival scrapes from 20/30 (66.7%) patients showed specific cytoplasmic fluorescence with enterovirus 70 (EV 70) antiserum, suggesting EV 70 to be the etiologic agent of the epidemic.

Pneumococci in ocular disease of children and their treatment.

A total of 171 isolates of Streptococcus pneumoniae were obtained from eyes of children who had congenital dacryocystitis, congenital cataract and glaucoma, acute bacterial conjunctivitis, corneal ulceration, nasolacrimal duct block, or discharging socket, or who had developed ectropion, endophthalmitis and orbital cellulitis. The highest number of strains was obtained from cases of dacryocystitis (74.4%), followed by conjunctivitis (8.2%) and those having developed nasolacrimal duct block (7.6%). The least overall resistance was to erythromycin (17.6%) and chloramphenicol (31.0%). Erythromycin being unavailable for ocular use in India, chloramphenicol was reported to be one of the best drugs against pneumococcal ocular infections in children, the other being cloxacillin, a 2.5% solution of which is made from injectable cloxacillin and used as an ophthalmic preparation. Their use on patients has met with considerable success. Nineteen out of 20 isolates were typeable--the types being 3, 46, 8, 28, 29, 45, 21 and 18. To the best of our knowledge, this is the first report from a developing country of serotyping ocular strains of pneumococci.