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Infectious Keratitis Management: 10-Year Update.

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|September 13, 2025
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Summary
This summary is machine-generated.

Infectious keratitis (IK) diagnosis relies on corneal cultures, with bacteria being the most common cause. New procedural therapies like PACK-CXL and RB-PDAT show promise for treating this significant cause of ocular morbidity.

Keywords:
antimicrobial therapycorneal ulcerinfectious keratitis

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Infectious keratitis (IK) is a major cause of vision loss globally.
  • Current diagnostic methods for IK include corneal cultures, with molecular diagnostics like metagenomic deep sequencing (MDS) emerging.
  • Medical treatment for IK has seen limited advancement, while procedural options are under investigation.

Purpose of the Study:

  • To review pathogens causing IK at Bascom Palmer Eye Institute (BPEI) from 2011-2021.
  • To outline current BPEI management algorithms for IK.
  • To summarize the roles of corticosteroid therapy, PACK-CXL, and RB-PDAT in IK treatment.

Main Methods:

  • Retrospective analysis of 9326 corneal cultures performed at BPEI (2011-2021).
  • Review of BPEI clinical management protocols for IK.
  • Summary of literature on adjunctive therapies for IK.

Main Results:

  • Bacteria were the most frequently identified pathogens (83.4%) in positive cultures.
  • Fortified vancomycin and tobramycin are recommended first-line treatments based on sensitivity to *Pseudomonas aeruginosa* and *Staphylococcus aureus*.
  • PACK-CXL and RB-PDAT may be beneficial for corneal melting and fungal IK, respectively.

Conclusions:

  • Optimizing corneal culture techniques is vital for accurate diagnosis.
  • PACK-CXL and RB-PDAT represent promising advancements in IK therapy.
  • Current management relies on culture-guided antibiotic therapy, with procedural options offering new hope.