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Culture, quinolones start infection care
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CHARLOTTE, N.C.—Corneal specialists are quick to culture a corneal ulcer, "be it peripheral, central, large or small," according to Ron Melton, OD, in practice here.
If the lesion is unresponsive to first-line therapy with fluoroquinolones, the culture result can then guide future choices.
Randall Thomas, OD, a private practitioner in Concord, N.C., agreed that routine culture is the standard of care. However, he cautioned, patients with large central corneal ulcers should be referred to a fellowship-trained cornea/external disease specialist.
Pseudomonas is an aggressive bacterial species and the most common organism in contact lens-related ulcers. "Our biggest fear as clinicians is the Pseudomonas corneal ulcer," Melton said, "because it can evolve rapidly and lead to perforation of the eye in a short period of time if not treated properly."
Other common organisms causing bacterial corneal ulceration include Streptococcal, Staphylococcal and Serratia species.