Rola N Hamam | PubMed Health

PubMed2006

Recalcitrant post-LASIK Mycobacterium chelonae keratitis eradicated after the use of fourth-generation fluoroquinolone.

OBJECTIVE: To report a patient with Mycobacterium chelonae keratitis after LASIK and discuss therapeutic measures. DESIGN: Interventional case report and literature review. INTERVENTION: A healthy, 25-year-old man presented 6 weeks after LASIK with infectious keratitis in the left eye. Scrapings were obtained from the central stromal bed after lifting the flap and inoculated on culture media. MAIN OUTCOME MEASURES: Response to medical treatment. RESULTS: Mycobacterium chelonae was identified from stromal bed scrapings. The protracted course of the infection necessitated surgical debridement and flap amputation with slow and suboptimal response to prolonged (14 weeks) treatment with topical amikacin 3.3%, clarithromycin 1%, and levofloxacin 0.5%. The substitution of levofloxacin 0.5% with gatifloxacin 0.3% resulted in closure of the epithelial defect within 1 week and resolution of the infiltrates in 3 weeks. The combined regimen of gatifloxacin 0.3%, amikacin 3.3%, and clarithromycin 1% was continued for a total of 4 months. The patient remains infection free 1 year after stopping all antibiotics. CONCLUSION: Treatment of post-LASIK nontuberculous mycobacteria remains a challenge. Institution of combination therapy including fortified amikacin, clarithromycin 1%, and a fourth-generation fluoroquinolone appeared to be beneficial in this patient.

Adult↗

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Ophthalmology in proverbs and aphorisms.

After a comprehensive review of available texts and literature covering five millennia, the authors present a collection of ophthalmic proverbs and aphorisms with an examination of their applicability within current medical knowledge. A total of 74 ophthalmic proverbs and aphorisms were retrieved from 130 texts and divided into seven categories: (i) importance of vision ('The eyes, like sentinels, hold the highest place in the body'); (ii) definition of blindness and anatomical observations ('The eye is protected by the lashes, eyebrows, and orbit'); (iii) diseases of the eye such as presbyopia, sensitivity to light and dry eye ('Tear in the eye is jewel'); (iv) the eye as a window of the body; (v) vulnerability of the eye ('The eye cannot oppose an awl'); (vi) health behaviours and protection of sight ('Be gentle with two: women and eyes'), and finally; and (vii) nutrition and vision ('Carrots improve vision'). The majority of these proverbs and aphorisms can be used as a guide, not for prognosis, diagnosis or cure, but rather for ocular health promotion.

Aphorisms and Proverbs as Topic↗