Infectious keratitis in climatic droplet keratopathy

To report the ulcer characteristics, microbiologic data, and outcome of infectious keratitis associated with climatic droplet keratopathy (CDK), suggesting that CDK is a predisposing factor for infectious keratitis.

Medical records of 32 patients (34 eyes) in whom infectious keratitis was seen in association with CDK were retrospectively reviewed. Data were collected regarding the nature of CDK lesions, infiltrate characteristics, organisms isolated, and outcome.

CDK was peripheral in 16 (47.1%) eyes, central in 8 (23.5%), and diffuse in 10 (29.4%). The CDK lesions were nodular and elevated in all eyes. The infiltrate was adjacent to the CDK lesions in 28 eyes (82.4%). The infiltrate size (widest dimension) ranged 2-6 mm in 18 eyes (52.9%) and was >6 mm in 7 (20.5%). The infiltrate was full thickness in 15 eyes (44.1%) and was involving up to the middle third of the corneal stroma in another 18 (52.8%). Hypopyon was seen in all. Bacteria were commonly isolated. Staphylococcus epidermidis (six eyes) and Streptococcus pneumoniae (five eyes) were the common bacteria isolated. Resolution with medical treatment was seen in 20 (58.8%) eyes.

CDK is a predisposing factor for infectious keratitis. Treatment should be considered for advanced and nodular lesions, even if they are peripheral, to prevent infectious keratitis.