Case Series of Streptococcus pneumoniae Keratitis and Its Sequelae

Streptococcus pneumoniae is a more prevalent cause of corneal ulcers in developing countries than in developed countries. We report five cases of corneal ulcers attributed to this organism with a literature review on bacterial cornea ulcers. Among the patients, four had underlying systemic illnesses while one was otherwise healthy. Four patients were presented with visual acuity worse than 6/60, and one patient had a visual acuity of 6/18. Two of the patients developed corneal perforation, which required tectonic penetrating keratoplasty. For visual outcome, two patients improved to visual acuities of 6/24 and 6/12, while three others had hand movement (HM) vision. All patients received broad-spectrum antibiotics, which were later adjusted based on culture sensitivity results. Notably, S. pneumoniae keratitis lacks specific ulcerative characteristics and can progress rapidly, frequently resulting in a guarded visual prognosis.