Cornea
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Comparative Study
Clinical aspects and prognosis of mixed microbial (bacterial and fungal) keratitis.
To investigate the predisposing factors, clinical presentations, treatment results, and prognosis of keratitis caused by mixed infectious agents (bacteria and fungi). ⋯ The most common risk factor for mixed bacterial and fungal keratitis was ocular trauma, and the most common combination was Staphylococcus epidermidis and Fusarium species. Usually, patients with mixed bacterial and fungal keratitis have poor prognosis. Thus, when the infectious keratitis is running an atypical course or found unresponsive to the initial medical treatment, the possibility of a mixed infection by bacterial and fungal organisms should be considered.
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Case Reports
Subconjunctival injections and povidone-iodine washings for the treatment of giant fornix syndrome.
Giant fornix syndrome is a chronic copiously purulent conjunctivitis seen in elderly patients with dehiscence of the levator palpebrae superioris aponeurosis. We report a case of giant fornix syndrome secondary to methicillin-resistant Staphylococcus aureus conjunctivitis that was recalcitrant to standard treatment modalities, and we describe 2 novel interventions for this condition, which succeeded in eradicating the infection. ⋯ In patients with giant fornix syndrome who are recalcitrant to or intolerant of aggressive topical and systemic therapy, supratarsal subconjunctival injections of antibiotics and corticosteroids and sweeping of the conjunctival fornices with povidone-iodine are 2 local treatments which may be useful in eradicating the infection.
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To present the clinical features, management, and outcomes of 4 cases of bee sting injury to the cornea and conjunctiva. ⋯ Ocular surface bee stings with retained stingers are rarely reported. A potential triad of penetrating, immunologic, and toxic injury must be taken into consideration. Vision can be restored by early removal of the sting and topical medication.