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Unsuspected infectious keratitis in host corneal buttons
T D Lindquist1, J D Cameron, V R Havener
1Department of Ophthalmology, University of Washington School of Medicine, Seattle.
Survey of Ophthalmology
|March 1, 1989
Summary
Undiagnosed infectious keratitis can occur before corneal transplants. Post-transplant histopathology revealed hidden infections, highlighting the need for antimicrobial therapy and noting contact lenses can mask symptoms.
Area of Science:
- Ophthalmology
- Pathology
Background:
- Infectious keratitis is a potential complication in patients undergoing penetrating keratoplasty.
- Preoperative diagnosis of infectious keratitis can be challenging.
Observation:
- Five cases of previously unknown corneal infections were diagnosed post-penetrating keratoplasty via histopathologic examination.
- Soft contact lenses and advanced bullous keratopathy can mask clinical signs of infectious keratitis.
Findings:
- Histopathologic examination with specialized stains is crucial for identifying unsuspected infectious keratitis.
- Early detection through histopathology can guide necessary postoperative antimicrobial therapy.
Implications:
- Histopathology is vital for diagnosing masked infectious keratitis in corneal transplant patients.
- Physicians should consider infectious keratitis even when masked by contact lens wear or bullous keratopathy.
- Prompt antimicrobial treatment based on histopathologic findings can improve outcomes.