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Pathogens
- Bacteria: Pseudomonas , Staphylococcus aureus, Streptococci (S. pyogenes, S. pneumoniae)
- Acanthamoeba
- Fungi: Candida, Fusarium, Aspergillus
Work-up
- Photodocumentation
- Specimen collection for:
- Infiltrate >1mm or involving the central visual axis or no response to initial therapy
- For non-central infiltrate <1mm: Swab not mandatory, low likelihood of pathogen detection
- Optimal: Direct examination, culture for bacteria + fungi, +/- viral PCR (HSV, VZV)
- Consider sending in contact lens case including contact lens to microbiology
- Especially if Acanthamoeba is suspected, otherwise not very helpful as cases are often contaminated
Treatment
- depending on suspected pathogen
Follow-up
- daily until improvement
- Cave: Avoid contact lens use until fully healed (preferably 1 week longer after therapy cessation)
Sources
- EyeWiki Contact lens complications
- The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
- Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)
- 1 Foto: Seraina Tscharner