Abstract
In order to report fungal keratitis in patients of ocular rosacea, a retrospective review of all cases of fungal keratitis was undertaken. Cases in which ocular rosacea coexisted were identified and included in the study. The clinical course of patients thus identified was studied from the medical records and outcomes were evaluated. A total of three cases of fungal keratitis with coexisting ocular rosacea were identified. All three patients were known cases of acne rosacea with an intermittent, irregular treatment for the same. Previous history of contact lens use, ocular surgery or trauma was not present in any of the cases. Microbiological evaluation revealed Aspergillus flavus as the causative organism in two patients and an unidentified hyaline fungus in the third. Patients received simultaneous therapy for fungal keratitis and ocular rosacea. The ocular surface completely stabilized and the infiltrate resolved in all three cases. The chronic ocular surface changes and induced inflammation in ocular rosacea, along with the instillation of topical steroids for therapy, may create an environmental milieu favorable for fungal keratitis. Microbiological evaluation should be considered, even in cases of suspected sterile keratitis, prior to treatment with topical steroids, so as to prevent the possible worsening of an associated infective corneal condition.
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References
Borrie P (1953) Rosacea with special reference to its ocular manifestations. Br J Dermatol 65:448–457. doi:10.1111/j.1365-2133.1953.tb13185.x
Robertson DM, Cavanagh HD (2005) Pseudomonas aeruginosa keratitis in an atopic silicone hydrogel lens wearer with rosacea. Eye Contact Lens 31:254–256. doi:10.1097/01.ICL.0000159230.16447.1A
Gopinathan U, Garg P, Fernandes M et al (2002) The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in south India. Cornea 21:555–559. doi:10.1097/00003226-200208000-00004
Ghanem VC, Mehra N, Wong S et al (2003) The prevalence of ocular signs in acne rosacea. Cornea 22:230–233. doi:10.1097/00003226-200304000-00009
Wise G (1943) Ocular rosacea. Am J Ophthalmol 26:591–609
Akpek EK, Merchant A, Pinar V et al (1997) Ocular rosacea: patient characteristics and follow-up. Ophthalmology 104:1863–1867
Afonso A, Sobrin L, Monroy DC et al (1999) Tear fluid gelatinase B activity correlates with IL-1 concentration and fluorescein clearance in ocular rosacea. Invest Ophthalmol Vis Sci 40:2506–2512
Dougherty JM, McCulley JP (1986) Bacterial lipases and chronic blepharitis. Invest Ophthalmol Vis Sci 27:486–491
Acknowledgements
Financial support came from Aditya Jyot Research Foundation, Dadar, Mumbai, India. The authors do not have any financial interest in the materials and methods used in the study.
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Jain, V., Shome, D., Sajnani, M. et al. Fungal keratitis associated with ocular rosacea. Int Ophthalmol 30, 239–244 (2010). https://doi.org/10.1007/s10792-009-9311-1
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DOI: https://doi.org/10.1007/s10792-009-9311-1