Laboratory Diagnosis Of Ocular Infections.

The eye is predisposed to many specific infections by microorganisms. Common ocular infections such as conjutivitis, and corneal ulcers can be due to a variety of different organisms such as Acanthomoeba, staphylococcus, and streptococcus. Typically in the optometric practice, patients suffering these types of infections are dealt with in a generic manner regardless of the causative organism. In most cases the practitioner attempt to correctly guess the causative organism and treat accordingly, they see the patient two days later and assess whether the antibiotic is working or not. If this therapy is not effective, an additional or substitute drug is prescribed at that time. Again the patient is seen a few days later and the cycle continues. One of the ways practitioners prevent this circle is to prescribe a strong, wide spectrmn antibiotic. This usually eliminates the need for substituting or adding drugs. It has been noted, however, that some strains of bacteria are evolving and becoming resistant to some of these antibiotics, penicillin for example. This is forcing us, as optometrists, to re-evaluate the methods of treatment for these types of problems. One of the
first things that can be done is to specifically identify the causative organism and treat the infection with the drug that is specific to that organism. To do this, samples must be taken from the site of ocular infection and cultured on media. After the sample is cultured, the bacteria can be identified through staining. This type of treatment eliminates the unnecessary exposure of antibiotics to bacteria not responsible for the problem. Although it may not be an economical or efficient way to deal with this problem in the private practice it should definitely be added to the College of Optometry to give the future clinicians a background in this complicated field Correctly identifying the causative organism in an ocular infection is a very delicate and specialized task. The following information will insure the correct and standard procedure for acquiring, culturing and identifying the bacteria fer treatment purposes. ·