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Spectrum of microbial pathogens in ophthalmic infections has shifted due to modern medicine
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BOSTON — Modern ophthalmic techniques and procedures have effectively lowered the incidence of microbial keratitis, but they have also altered the spectrum of infectious pathogens that ophthalmologists need to be aware of, a speaker said here.
 Ivan R. Schwab |
The advent of public health in the late 19th century and continuing to this date is largely responsible for a significant decrease in microbial transmission in general, and microbial keratitis specifically, compared with historical trends, Ivan R. Schwab, MD, said at the World Cornea Congress preceding the American Society of Cataract and Refractive Surgery meeting.
However, Dr. Schwab added, the introduction of new surgical techniques that have expanded ophthalmology's ability to treat and to extend care to previously underserved populations has also lead to greater potential for microbial colonization with unique organisms. Chief among the facilitators of microbial keratitis in modern ophthalmology, Dr. Schwab said, is the rise of contact lens wear, which has increased the importance of such microbes as Acanthamoeba and Pseudomonas.
"This has become the new foreign body, replacing vegetable trauma as the major cause of microbial keratitis," Dr. Schwab said.
Likewise, while newer antibiotics have proven effective in treating bacterial infections of the eye, they have also given rise to more powerfully resistant bacteria species such as vancomycin-resistant Enterococcus and methicillin-resistant Staphylococcus aureus.
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