CORNEAL SUPERINFECTION IN ACUTE HEMORRHAGIC CONJUNCTIVITIS

Purpose. This study aimed to evaluate the clinical profile, microbial spectrum, management modalities, and visual outcome in cases of cornea l superinfection that occurred after an epidemic of acute hemorrhagic conjunctivitis. Method. A retrospective analysis of 14 eyes of 13 pati ents who were referred to a tertiary eye-care center with corneal ulce ration after an episode of acute hemorrhagic conjunctivitis was undert aken. The parameters analyzed were age, sex, prior use of topical medi cations, predisposing factors, ulcer characteristics, organisms isolat ed, success of medical therapy and surgery, and visual outcome. Result s. A definite history of topical corticosteroid use to treat acute hem orrhagic conjunctivitis was elicited in 12 (86%) eyes. Cultures were p ositive in 86% (12/14) eyes. Organisms isolated were Pseudomonas aerug inosa (three eyes 25%), Fusarium species (three eyes, 25%), Aspergillu s species (two eyes, 16%), and Staphylococcus aureus (two eyes, 16%). Mixed infection occurred in two patients. After discontinuation of top ical corticosteroids, all patients received antimicrobial therapy. The keratitis resolved in seven eyes. Therapeutic penetrating keratoplast y was required in five eyes. Two patients were lost to follow-up. Conc lusions. Corneal superinfection may occur after acute hemorrhagic conj unctivitis. Use of topical corticosteroids to treat acute hemorrhagic conjunctivitis may predispose an already compromised cornea to develop microbial keratitis and such a practice should be discouraged.