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Evaluating Therapeutic and Chemical Toxicity Using Organ-Cultured Porcine Corneas and Epithelial Wound Healing
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Over-Treated Corneal Abscess May Be Toxic Keratopathy
P Rubino1, J G Orsoni, A Rampini
1Institute of Ophthalmology, University of Parma, Parma, Italy.
Case Reports in Ophthalmology
|August 26, 2010
Summary
Suspected fungal keratitis unresponsive to treatment may actually be toxic keratopathy from over-treatment. Discontinuing unnecessary antimicrobial drops improved the patient's corneal abscess.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Long-standing keratitis unresponsive to antimicrobials often raises suspicion for fungal infection.
- Prompt diagnosis and treatment are crucial for managing corneal diseases.
Observation:
- A 65-year-old male diabetic patient presented with a corneal abscess unresponsive to 6 weeks of antibiotic and antifungal therapy.
- Corneal biopsy was performed after a 72-hour washout period to identify potential bacterial or fungal pathogens.
Findings:
- No bacteria or fungi were cultured from the corneal biopsy.
- Discontinuation of previous topical treatments and maintenance with preservative-free artificial tears led to significant clinical improvement within 2 weeks.
Implications:
- Over-treatment of corneal conditions, particularly with empirical antifungal agents, can lead to iatrogenic toxic keratopathy.
- Careful evaluation and de-escalation of treatment are essential when corneal conditions fail to respond as expected.
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