Bacterial keratitis is inflammation of the cornea which is due to bacterial organisms. Causative organisms are mostly pyogenic bacteria such as pseudomonas, staphylococcus aureus, pneumococcus, Neisseria gonorrhoeae and E.coli.
These organisms invade throw epithelium and break in the surface, which result in diminished resistance to epithelium, necrosis and desquamation.
To treat the keratitis following objectives are to be considered
● To Control the infection
> Topical antibiotics drop > Gentamycin, Tobramycin, ciprofloxacin, moxifloxacin.
> Antibiotic ointment > polyfax, Tobramycin.
> Subconjunctival injection > 0.5ml of antibiotic.
> Systemic antibiotics are not used because the cornea is avascular.
● Relief of the pain
> Cycloplegic > atropine 1% by relieving the spasm of the ciliary body and prevent posterior synechiae formation.
> Analgesics > Oral or injection form.
> Antiglaucoma drugs > carbonic anhydrase inhibitor and beta-blocker decreased intraocular pressure.
● Treatment of perforated corneal ulcer
> Antiglaucoma drug to lower pressure.
> Paracentesis is done to lower pressure.
> Bandage contact lens to provide support.
> Pressure bandage to provide support.
> Conjunctival flap for mechanical support.
> Therapeutic corneal graft.