Does identification of the causal organism of corneal ulcers influence the outcome?

To investigate whether identification of the causal organism in corneal ulcers influences their outcome.

We retrospectively studied 114 patients, 72 males and 42 females aged 6-89 years, admitted to this eye clinic during the years 1994-2000 on account of an infectious corneal ulcer. Their examination included a detailed history, visual acuity measurement, and biomicroscopy in everyday follow-up. The ulcers were classified according to their severity and outcome. We assessed the cases where cultures had been done, reviewed the results, and searched for a possible correlation between the outcome and the fact of culturing the ulcer and identifying the causal organism.

Of the 114 corneal ulcers studied, 23 were mild, 49 moderate, and 42 severe. Fifty (44%) had not been cultured, but 64 ulcers (56%) had been cultured, with a positive result in 37 cases (58%), Staphylococcus and Pseudomonas species being the most common organisms found. In moderate and severe ulcers, there was a tendency to a higher proportion of successful outcome for cultured ulcers, but with no significant correlation.

Despite a tendency towards favorable results in culture-positive corneal ulcers, the influence of the detection of the organism on their outcome has not been proved. The role of the initial broad-spectrum antibiotic therapy remains important.