Outpatient treatment of microbial corneal ulcers

Outpatient and inpatient management of culture-proved microbial corneal ulcers was evaluated. Twenty-six consecutive patients were reviewed. Twenty had been managed as outpatients, six as inpatients. All ulcers were treated with intensive topical antimicrobial therapy, and all steadily healed, as evidenced by epithelialization and resolution of infiltrate. None progressed to extreme stromal thinning, descemetocele, or perforation. Inpatients and outpatients did not differ in terms of healing time, although this can vary considerably for the same causative organism. Complete epithelialization took two to 56 days. Pseudomonas ulcers healed in seven to 42 days (mean, 22 days), which is similar to previously published reports of inpatient therapy. This study suggests that with careful patient selection and follow-up, infectious corneal ulcers can be successfully managed on an outpatient basis.