Ocular streptococcal infections

Streptococcal infections are an important cause of corneal ulcers, endophthalmitis, conjunctivitis, and dacryocystitis. We retrospectively reviewed 53 ocular streptococcal infections diagnosed and followed at Wills Eye Hospital between January 1, 1984, and July 1, 1986. Corneal ulcers (23 of 53; 43%) and endophthalmitis (18 of 53; 34%) constituted a majority of the streptococcal infections in this series. Streptococcal infection was also a common cause of conjunctivitis, but clinical follow-up data were sufficient for inclusion in this series in only a small fraction of conjunctivitis patients (9 of 70; 13%). Streptococcal corneal ulcers and endophthalmitis were frequently associated with a poor visual outcome. When antibiotic sensitivity testing was done, approximately one third of the streptococcal isolates (13 of 38; 34%) were not sensitive to gentamicin. As topical gentamicin is frequently used by ophthalmologists, the possibility of streptococcal infection should be taken into account in the selection of antibiotics for conjunctivitis, corneal ulcers, endophthalmitis, and prophylaxis.