+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The utility of culturing corneal ulcers in a tertiary referral center versus a general ophthalmology clinic

The utility of culturing corneal ulcers in a tertiary referral center versus a general ophthalmology clinic

Ophthalmology 104(11): 1897-1901

Objective: The purpose of the study is to compare the utility of culturing corneal ulcers in a tertiary referral clinic and a general ophthalmology clinic. Design: A retrospective review of medical and microbiologic records was performed. Participants: One hundred fifty-seven patients with corneal ulcers were included in the study. Eighty-two ulcers were treated in the referral clinic and 75 ulcers were treated in the general ophthalmology clinic. Main Outcome Measures: The authors determined the percentage of corneal ulcers in each clinical setting that failed to respond to empiric therapy and required a culture-directed change in treatment. Results: One hundred fifty-seven ulcers were included. Eight (10%) of the 82 patients treated in the Cornea Clinic had treatment altered based on culture and sensitivity results. All 75 patients in the general clinic responded to empiric antibiotics, such that culture data never were required for modification of therapy (0%, P = 0.007), In contrast to patients treated in the Cornea Clinic, patients treated in the general clinic had smaller, more peripheral ulcers, shorter duration of symptoms, and fewer risk factors for corneal ulceration other than contact lens wear. Conclusions: Cornea specialists, who are referred the most severe cases, should consider culturing most corneal ulcers. However, it appears reasonable for general ophthalmologists to use culturing more judiciously. Patients with significant corneal ulcers should be cultured regardless of the clinic to which they present. However, small, peripheral ulcers respond extremely well to current, broad-spectrum antibiotics. Close follow-up is mandatory to discover the rare patient who will not respond to empiric therapy.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 009636801

Download citation: RISBibTeXText

PMID: 9373123

DOI: 10.1016/S0161-6420(97)30010-4

Related references

Characteristics and risk factors of corneal ulcers presenting to a tertiary referral center. IOVS 42(4): S884, March 15, 2001

Trends in contact lens-related corneal ulcers at a tertiary referral center. Cornea 31(10): 1097-1102, 2012

Clinical profile, evaluation, management and visual outcome of idiopathic intracranial hypertension in a neuro-ophthalmology clinic of a tertiary referral ophthalmic center in India. Annals of Indian Academy of Neurology 13(1): 37-41, 2010

Utility of a repeated EUS at a tertiary-referral center. Gastrointestinal Endoscopy 67(4): 610-619, 2008

Empiric management of severe corneal ulcers prior to referral to a tertiary care facility. Investigative Ophthalmology & Visual Science 35(4): 1669, 1994

Indications for corneal transplantation at a tertiary referral center in tehran. Journal of Ophthalmic & Vision Research 5(2): 82-86, 2010

Comparison of kimura spatula versus rayon swab for culturing microbial corneal ulcers. Investigative Ophthalmology & Visual Science 37(3): S594, 1996

Changing referral patterns of infectious corneal ulcers to a tertiary care facility in south India - 7-year analysis. Ophthalmic Epidemiology 19(5): 297-301, 2012

Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic. Ophthalmology 106(11): 2154-2160, 1999

Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014. Clinical Ophthalmology 10(): 1007-1013, 2016

Changing indications and surgical techniques for corneal transplantation between 2004 and 2009 at a tertiary referral center. Middle East African Journal of Ophthalmology 19(3): 323-329, 2013

Impact of a Movement Disorders Clinic on the trends of Parkinson's Disease Consultations at a Tertiary Referral Center. Revista de Investigacion Clinica; Organo del Hospital de Enfermedades de la Nutricion 68(4): 176-180, 2016

Utility of international store-and-forward teledermatopathology among a cohort of mostly female patients at a tertiary referral center in Afghanistan. International Journal of Women's Dermatology 4(2): 83-86, 2018

Trends in Indications and Techniques of Corneal Transplantation from 1999 through 2015 at a Tertiary Referral Center in Athens, Greece. Journal of Ophthalmology 2018: 9132083-9132083, 2018

Comprehensive First-Line Magnetic Resonance Imaging in Hypertension: Experience From a Single-Center Tertiary Referral Clinic. Journal of Clinical Hypertension 19(1): 13-22, 2016