Algorithm guides treatment of bacterial keratitis, reduces costs
Culturing all suspected cases of bacterial eye infection can be costly, time consuming, and often unnecessary. A new algorithm developed at Mass. Eye and Ear, consisting of a simple set of rules, now helps clinicians in the Emergency Department identify cases that (a) need to be cultured and immediately started on aggressive broad-spectrum topical antibiotics every hour, or (b) do not need to be cultured and can be treated with a single topical antibiotic. Once the algorithm is validated, it will be made available to other centers to help guide treatment of bacterial keratitis (corneal ulcer) cases.
Imaging expedites the diagnosis of fungal and Acanthamoeba corneal infections
When a patient’s corneal ulcer is not responding to intensive antibiotic drops, ophthalmologists should consider referring their patient to a cornea specialist with access to in vivo confocal microscopy. This type of imaging allows physicians to view large infectious organisms that have invaded the cornea. By identifying the cause of the ulcer, adjustments can be made to the treatment regimen in order to more appropriately target the correct organism. For instance, if fungal elements are seen in the cornea, topical anti fungal therapy can be initiated and fortified antibiotic drops (which have some toxic side effects) can be reduced or stopped. Imaging using in vivo confocal microscopy is available at Mass. Eye and Ear.
Rapid diagnostic testing for posterior eye infections
A new, state-of-the-art rapid PCR diagnostic test for infections of the eye, developed at Mass. Eye and Ear, will soon hasten the accurate diagnosis and treatment of the most common agents of infectious uveitides. This highly sensitive test – which targets cytomegalovirus, varicella zoster, herpes simplex 1 and 2, and Toxoplasmosis gondii – takes less than two hours. Upon Clinical Laboratory Improvement Amendments (CLIA) approval, the test will be employed in routine clinical care and is expected to benefit patients with infectious retinitis, posterior uveitis, and other posterior eye infections.