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Published on: November 12, 2015
Therapy for contact lens-related ulcers
1Department of Ophthalmology, University of Florida, Gainesville, Florida, USA.
Purpose Of Review:
The current review covers the current literature and practice patterns of antimicrobial therapy for contact lens-related microbial keratitis (CLMK). Although the majority of corneal ulcers are bacterial, fungus and acanthamoeba are substantial contributors in CLMK and are harder to treat due to the lack of commercially available topical medications and low efficacy of available topical therapy.
Recent Findings:
Topical antimicrobials remain the mainstay of therapy for corneal ulcers. Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers. Antibiotic resistance is a persistent problem. Fungal ulcers are less responsive to topical medications and adjunct oral or intrastromal antifungal medications may be helpful. Acanthamoeba keratitis continues to remain a therapeutic challenge but newer antifungal and antiparasitic agents may be helpful adjuncts. Other novel and innovative therapies are being studied currently and show promise.
Summary:
Contact lens-associated microbial keratitis is a significant health issue that can cause vision loss. Treatment remains a challenge but many promising diagnostics and procedures are in the pipeline and offer hope.
Insights
Antimicrobial therapy for contact lens-related microbial keratitis (CLMK) faces challenges with fungal and acanthamoeba infections. New treatments are being developed to combat antibiotic resistance and improve outcomes for this vision-threatening condition.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Contact lens-related microbial keratitis (CLMK) is a significant cause of vision loss.
- Bacterial infections are most common, but fungal and acanthamoeba keratitis are challenging to treat.
- Limited topical medication options and low efficacy of current therapies contribute to treatment difficulties.
Purpose of the Study:
- To review current literature and practice patterns for antimicrobial therapy in CLMK.
- To highlight challenges in treating fungal and acanthamoeba keratitis.
- To discuss emerging and novel therapeutic approaches.
Main Methods:
- Literature review of antimicrobial therapy for CLMK.
- Analysis of current treatment strategies for bacterial, fungal, and acanthamoeba keratitis.
- Evaluation of antibiotic resistance patterns and novel treatment modalities.
Main Results:
- Topical antimicrobials are the primary treatment for corneal ulcers.
- Fluoroquinolones can be used for small bacterial ulcers, but antibiotic resistance is a concern.
- Fungal and acanthamoeba keratitis are less responsive to conventional therapy, requiring adjunct oral/intrastromal antifungals or newer agents.
Conclusions:
- CLMK is a serious condition with potential for vision loss.
- Effective treatment remains challenging, particularly for non-bacterial forms.
- Promising new diagnostics and therapies are under development, offering hope for improved patient outcomes.
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