Keratitis, suppurative

H16.8

DESCRIPTION

Painful red eye with corneal lesion that stains with fluorescein and has creamy white appearance. Contact lenses are a major risk factor, especially for fungal infections. Have a high index of suspicion for fungal infection if HIV positive or there is a history of injury to eye with plant matter.

MEDICINE TREATMENT

Empiric therapy until culture results become available:

Bacterial infection:

  • Fluoroquinolone ophthalmic drops, e.g.:
  • Ciprofloxacin 0.3%, ophthalmic drops, instil 1 drop hourly for 3 days.
    • Then reduce frequency to 1 drop 3–4 hourly.

LoEIII [14]

Fungal infection:

  • Natamycin 5%, ophthalmic drops, instil 1 drop 1–2 hourly for 3–4 days. (Specialist prescribed).
    • Then reduce frequency to 1 drop 3–4 hourly.
    • Continue for 14–21 days until resolution of infection.

REFERRAL

  • Hypopyon (pus in the anterior chamber)
  • No facilities for microscopy, culture and sensitivity.