[Corneal ulcer. Current analysis from specialized ambulatory care of a clinic]

A review of 115 cases of ulcerative keratitis that were diagnosed and treated at the specialized ambulatory care center for infectious eye diseases at the 2. Department of Ophthalmology over a period of eight years (January 1983-April 1991) is presented. In the analysis of the etiology nearly half (47.7%) were observed following a trauma to the epithelium, 38 (= 33.0%) were associated with contact lens wear and the third largest group (10.4%) was associated with lid problems. It is apparent that over the course of the last years the spectrum of microorganisms associated with this localized inflammation has shifted: the prevalence of Staphylococci (1983-1986 = 65%) has decreased, whereas the incidence of gram-negative rods increased (1987-1990 = 49%). In 19% Pseudomonas aeruginosa could be isolated, mostly associated with soft contact lens wear. A total of 37.5% of the staphylococci isolates were found to be resistant to gentamicin, most probably as a consequence of the widespread, indiscriminate use of this antibiotic. An updated treatment schedule is presented.