Pseudomonas bacilli are a common source of corneal infection, especially in contact lens wearers. Prompt diagnosis and treatment are essential to reduce the risk of vision loss.

The Bottom Line

Pseudomonas infection of the cornea is potentially vision-threatening and requires prompt and aggressive treatment. Topical antibiotic therapy should be initiated pending culture results. Typically, this involves frequent dosing with one of the newer broad-spectrum fluoroquinolones. Depending on the seriousness and course of the infection, switching to fortified antibiotics may be indicated. Pseudomonas infection today is most often associated with contact lens wear, and contact lens patients should be counseled to be alert to the symptoms of possible infection and to see an eye physician if they develop a red or irritated eye.

Penny A. Asbell, MD, is director of the Cornea Service and Refractive Surgery Center and professor in the department of ophthalmology at Mount Sinai School of Medicine in New York, NY. Dr. Asbell is on the speakers’ bureau of Alcon, Allergan, Inspire, Vistakon Pharmaceuticals, and Santen. Laia Bisbe, MD, is a visiting cornea fellow at Mount Sinai School of Medicine and a cornea and external eye disease consultant at Hospital Vall d’Hebron, Universtitat Autònoma de Barcelona, Barcelona, Spain. This article was written with the assistance of freelance medical writer William Kellner.
 

References

1. Keay L, Stapleton F, Schein O. Epidemiology of contact lens-related inflammation and microbial keratitis: a 20-year perspective. Eye Contact Lens. 2007 Nov;33(6 Pt 2):346-353.

Additional Reading
Asbell, PA, Stenson S. Ulcerative keratitis: survey of 30 years’ laboratory experience. Arch Ophthalmol. 1982;100:77-80.
Sokol J, Masur SK, Asbell PA, Wolosin JM. Layer-by-layer desquamation of corneal epithelium and maturation of tear facing membranes. Invest Ophthalmol Vis Sci. 1990;31(2):294-304.
Chidambaram JD. Recent advances in the diagnosis and management of bacterial keratitis. Int Ophthalmol Clin. 2007;47(3):1-6.
Thomas PA, Geraldine P. Infectious keratitis. Curr Opin Infect Dis. 2007 Apr;20(2):129-41.