Ulcerative fungal keratitis in a Brown Swiss cow.

An 11-year-old Brown Swiss cow was referred to the Farm Animal Department of the Veterinary Teaching Hospital in Zurich, Switzerland, because of lateral recumbency due to puerperal hemolytic anemia. The animal had developed enophthalmos due to dehydration at the time of presentation. Two days after hospitalization, the cow showed blepharospasm and epiphora of the right eye. Ophthalmic examination of the right eye revealed a fluorescein-positive, paraxial, superficial corneal ulcer with focal edema, and mild superficial neovascularization. White corneal stromal infiltrates were seen at the edges of the ulcer bed. After initial topical treatment with an antibiotic ointment (Neomycin 3.5 mg/g, Bacitracin 250 IU/g) three times a day, an increase in corneal infiltrates was noted on re-examination 2 days later. Several fluorescein-negative, punctate, stromal, white opacities were seen dorsal to the ulcer. Cytology demonstrated the presence of fungal hyphae. Topical treatment with 2% miconazole ointment and 0.36% K-EDTA eye drops six times daily and four times daily, respectively, from the second day and continued antibiotics three times daily resolved the clinical symptoms within 6 days. Fungal culture identified the fungal organism as Eurotium amstelodami.

Comparison of antibiotic drops placed in the conjunctival cul-de-sac to antibiotic ointment applied to the lid margin in reduction of bacterial colonization on the lid margin.

PURPOSE: To compare the efficacy of antibiotic drops placed in the conjunctival cul-de-sac to antibiotic ointment applied to the lid margin in reduction of bacterial colonization on the lid margin. METHODS: A randomized, prospective, single-masked study was conducted on 19 patients with culture-proven colonization of bacteria on the lid margins. Ophthalmic eligibility criteria included the presence of > or =50 colony-forming units/mL (CFU/mL) of bacteria on both right and left lids. Each patient received one drop of ofloxacin in one eye every night for one week, followed by one drop once a week for one month. In the same manner, each patient received bacitracin ointment (erythromycin or gentamicin ointment if lid margin bacteria were resistant to bacitracin) to the lid margin of the fellow eye. Quantitative lid cultures were taken at initial visit, one week, one month, and two months. Fifteen volunteers (30 lids) served as controls. Lid cultures were taken at initial visit, one week, and one month. RESULTS: Both antibiotic drop and ointment reduced average bacterial CFU/mL at one week and one month. Average bacterial CFU/mL reestablished to baseline values at two months. There was no statistically significant difference between antibiotic drop and ointment in reducing bacterial colonization on the lid margin. CONCLUSION: Antibiotic drops placed in the conjunctival cul-de-sac appear to be as effective as ointment applied to the lid margins in reducing bacterial colonization in patients with > or =50 CFU/mL of bacteria on the lid margins.