Corneal bacterial diseases

Purpose To present the main causes of corneal bacterial diseases and suggest an appropriate management. Bacterial keratitis is the most common cause of infected corneal ulceration. Methods The epidemiology of corneal bacterial diseases and their link with different risk factors will be studied. The initial presentation is important to determine the potential stain responsible for the infection and to assess the overall severity of the disease. Local and general criteria evaluations lead to a proper management. Bacterial identification plays a key-role in the etiological diagnosis. Results Contact lens wear, trauma, preexisting ocular disease and corneal surgery are the main risk factors for corneal bacterial disease. Specific signs to identify bacteria remain rare but the circumstances (contact lens wear, aspect of the infiltrate) can help to determine the first line treatment. However laboratory methods remain the only way to diagnose a corneal bacterial disease with certainty. The aspect of the infiltrate, the intraocular involvement and an immunosuppressed patient may influence the outcome. The treatment is based on an initial broad-spectrum antibacterial therapy with secondary adaptation to the identified bacteria. Conclusion Multiple microorganisms are involved in corneal diseases. The local and systemic risk factors have to be identified to treat these diseases in emergency still considered as a leading cause of visual loss.