Severe sclerokeratitis due to Pseudomonas aeruginosa in non-contact-lens wearers

Purpose To review the clinical presentation, treatment and outcome in four cases of severe anterior segment infection by Pseudomonas aeruginosa unrela ted to contact lens wear. Methods Four cases presenting over an 18 month period were reviewed. Results The cases had variable presenting features and outcomes. Complicati ons such as persistent infection, corneal thinning and phthisis bulbi were noted. Possible factors influencing adherence and tissue disruption are dis cussed. Conclusions Suspicion of infection by P. aeruginosa and prompt isolation of the organism is needed early in the course of disease. Intensive and prolo nged treatment with parenteral and topical antibiotics combined with judici ous use of topical steroid gives the best chance of a favourable outcome.