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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

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Emergency: requires immediate attention
Bacterial corneal ulcer - External and Internal Eye
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Bacterial corneal ulcer - External and Internal Eye

Contributors: Lauren Patty Daskivich MD, MSHS, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD
Other Resources UpToDate PubMed

Synopsis

A bacterial corneal ulcer, or bacterial keratitis, is an infection of the corneal stroma that causes rapid visual loss and pain. Infectious corneal ulcers need to be treated as soon as possible to preserve vision. If left untreated, a bacterial infection can lead to perforation of the cornea, loss of vision, and even loss of the eye.

Risk factors that can lead to bacterial keratitis include contact lens wear, eye trauma, previous ocular surgery, dry eye, immunosuppression, and any other process that causes breakdown of the ocular surface.

Patients with a bacterial corneal ulcer will complain of eye pain, light sensitivity, red eyes, and possibly reduced vision. The rapidity of the onset and progression of symptoms depends on the virulence of the bacteria causing the infection.

History is very important in giving clues as to the most common organism causing the infection. Bacterial keratitis in a contact lens wearer is frequently caused by gram-negative organisms, such as Pseudomonas aeruginosa, whereas ulcers in patients with blepharitis are more commonly due to gram-positive organisms.

Note: Per January 20, 2023, the Centers for Disease Control and Prevention (CDC) is investigating a multistate cluster of carbapenem-resistant Pseudomonas aeruginosa with Verona integron-mediated metallo-β-lactamase and Guiana extended-spectrum-β-lactamase (VIM-GES-CRPA). As of March 14, 2023, the CDC identified 68 patients in 16 states with with VIM-GES-CRPA. At this time, CDC and FDA recommend clinicians and patients stop using EzriCare or Delsam Pharma's Artificial Tears products. The isolates have remained cefiderocol sensitive.

Codes

ICD10CM:
H16.009 – Unspecified corneal ulcer, unspecified eye

SNOMEDCT:
231893002 – Bacterial corneal ulcer

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:06/26/2019
Last Updated:04/09/2023
Copyright © 2023 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Bacterial corneal ulcer - External and Internal Eye
A medical illustration showing key findings of Bacterial corneal ulcer : Eye pain, Photophobia, Corneal diffuse white infiltrate, Corneal focal white infiltrate, Unilateral distribution, Vision loss, Corneal ulcer, Conjunctival injection, Hypopyon, Mucopurulent eye discharge
Clinical image of Bacterial corneal ulcer - imageId=3104703. Click to open in gallery.
Copyright © 2023 VisualDx®. All rights reserved.