Severe sclerokeratitis due to Pseudomonas aeruginosa in noncontact-lens wearers.

PURPOSE: To review the clinical presentation, treatment and outcome in four cases of severe anterior segment infection by Pseudomonas aeruginosa unrelated to contact lens wear.

METHODS

Four cases presenting over an 18 month period were reviewed.

RESULTS

The cases had variable presenting features and outcomes. Complications such as persistent infection, corneal thinning and phthisis bulbi were noted. Possible factors influencing adherence and tissue disruption are discussed.

CONCLUSIONS

Suspicion of infection by P. aeruginosa and prompt isolation of the organism is needed early in the course of disease. Intensive and prolonged treatment with parenteral and topical antibiotics combined with judicious use of topical steroid gives the best chance of a favourable outcome.