American Society of Cataract and Refractive Surgery Meeting

American Society of Cataract and Refractive Surgery Meeting

Source:

Al-Mohtaseb Z. Big and bad bacteria: Infectious keratitis. Presented at: American Society of Cataract and Refractive Surgery meeting; July 23-27, 2021; Las Vegas.

Disclosures: Al-Mohtaseb reports she is a consultant for Alcon and CorneaGen and on the speakers bureau for Bausch + Lomb and Carl Zeiss.
July 24, 2021
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Diagnosis key for proper treatment of infectious keratitis

Source:

Al-Mohtaseb Z. Big and bad bacteria: Infectious keratitis. Presented at: American Society of Cataract and Refractive Surgery meeting; July 23-27, 2021; Las Vegas.

Disclosures: Al-Mohtaseb reports she is a consultant for Alcon and CorneaGen and on the speakers bureau for Bausch + Lomb and Carl Zeiss.
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LAS VEGAS — Many cases of Acanthamoeba keratitis are misdiagnosed, a presenter said during Cornea Subspecialty Day at the American Society of Cataract and Refractive Surgery meeting.

Zaina Al-Mohtaseb, MD, said that cases of Acanthamoeba keratitis are often misdiagnosed as herpetic keratitis due to the appearance of the dendrite. Approximately 37% to 47% of these cases can be misdiagnosed, according to previous studies.

Zaina Al-Mohtaseb

Steroid use should be avoided unless absolutely necessary for cases of Acanthamoeba keratitis because studies have shown worse outcomes after steroid treatment. Al-Mohtaseb said topical steroids can be used early in the course of treatment if severe corneal ulcers are present and for specific etiologies of bacterial keratitis.

“If you have a diagnosis in the severe corneal ulcer, the other thing to think about is, ‘Why are you using the steroids?’” she said. “In a small infection, if there isn’t much inflammation or scarring, why put that topical steroid on there?”

At times, empiric therapy is appropriate for keratitis, and that treatment should be specific to the infectious organism.

“Diagnosis is really key,” Al-Mohtaseb said. “Stopping and thinking about getting that diagnosis — whether it is a biopsy or even a therapeutic keratoplasty — is really important.”