Abstract FEAR of enhancing fungal growth has prohibited the use of local administration of corticosteroid in the treatment of keratomycosis,1-4 although its value in the therapy of other forms of microbial-induced inflammatory corneal disease is well documented.5,6 This case report describes the management of a deep corneal abscess which followed trauma. Combined corticosteroid-antifungal therapy followed by penetrating keratoplasty was successful in eliminating the fungal infection and attaining useful vision. Report of a Case The patient, aged 23, was struck in the right eye by a strand of barbed wire while serving as a noncombatant in Vietnam. Although his vision immediately blurred and he experienced some pain, he did not seek medical attention until two days later. He was immediately admitted to the hospital with the diagnosis of hypopyon ulcer, and for the next three weeks he was treated with locally and systemically administered medications that included a variety of References 1. Mitsui Y, Hanbusa J: Corneal infections after cortisone therapy . Brit J Ophthal 39:244, 1955.Crossref 2. Zimmerman LE: Keratomycosis . Survey Ophthal 8:1-25, 1963. 3. Zimmerman LE: Mycotic keratitis . Lab Invest 11:1151-1160, 1962. 4. Ellison AS, Newinati E, Kaufman HE: Chemotherapy of keratomycosis . Amer J Ophthal 68:812, 1969. 5. Aronson SB, Moore TE Jr: Corticosteroid therapy in central stromal keratitis . Amer J Ophthal 67:873-896, 1969. 6. Laibson PR: Cornea and sclera . Arch Ophthal 83:637-657, 1970.Crossref 7. Wiedman M, Gunderson T: Conjunctival flaps and cautery , in Dchlman CH (ed): Corneal Edema . Boston, Little Brown & Co, 1970, pp 637-653. 8. Moore TE Jr, Aronson SB: The corneal graft: A multiple variable analysis of the penetrating keratoplasty, monograph. Amer J Ophthal, to be published. 9. Aronson SB, Moore TE Jr, Williams FC, et al: Corticosteroids in infectious ocular disease , in Kaufman HE (ed): Ocular Anti-inflammatory Therapy . Springfield, Ill, Charles C Thomas Publisher, 1970, pp 14-29. 10. Newmark E, Ellison AC: Combined pimaricin and dexamethasone therapy of keratomycosis. Read before the spring meeting of the Association for Research in Ophthalmology, Sarasota, Fla, 1970. 11. Forster RK: Further observations in treatment of keratomycosis with pimaricin. Read before the spring meeting of the Association for Research in Ophthalmology, Sarasota, Fla. 12. Louria DB, Dinee P: Amphotericin B in treatment of disseminated moniliasis . JAMA 174:273-280, 1960.Crossref 13. Utz JP: Current concepts in therapy: Chemotherapeutic agents for systemic mycosis . New Eng J Med 268:938-940, 1963.Crossref
Archives of Ophthalmology – American Medical Association
Published: Oct 1, 1971
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