Corneal infections

This is a potentially sight threatening condition. Avoid using steroid if corneal infection can not be excluded as steroid can worsen the infection.


  • Painful red eye
  • Photophobia
  • There may be a history of contact lens use or previous herpes keratitis.
  • The visual acuity is reduced
  • Fluorescein dye reveals corneal defect
  • In severe bacterial infection, there may be hypopyon (pus in the anterior chamber)
  • Refers within 24 hours 
  • In herpes keratitis, topical acyclovir 3% five times a day is prescribed for one week
  • In bacterial corneal ulcer, the patient may be admitted for intensive antibiotic treatment 

  • if severe or treated as an out-patient if mild.
Figure 1.
This patient suffers from herpetic keratitis. . Fluorescein staining reveals 
a dendritic ulcer typical of herpes keratitis. This is treated with topical
3% acyclovir
Figure 2
This woman presented with a one day history of severe right ocular pain. 
She used extended contact lenses and was not complying with the cleaning 
instruction. The picture shows a corneal ulcer with hypopyon. She was 
admitted for intensive antibiotics. Culture of the ulcer grew Psuedomonas 
aeruginosa. The infection responded to combined intensive gentamicin and 
cefuroxime eyedrops.

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