Topical Corticosteroids and Fungal Keratitis

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Abstract

The incidence of experimentally produced keratitis with Candida albicans was studied in traumatized rabbit eyes; these eyes, 23 out of 30 treated with 1 per cent hydrocortisone drops, 16 out of 30 treated with 1 per cent medrysone drops, and 12 out of 30 treated with control drops without corticosteroid, developed infection as demonstrated by culture of corneal tissue. The increased number of infections in the hydrocortisone group compared with the controls was statistically significant whereas the incidence of infections in the medrysone group did not differ statistically from the control or the hydrocortisone groups. These restdts suggest that 1 per cent medrysone should be compared with concentrations of hydrocortisone more dilute than 1 per cent before any qualitative differences between these steroids are assumed. Progressions of keratitis to hypopyon occurred in 10 eyes treated with hydrocortisone drops and in 3 eyes treated with medrysone drops during the period of experimental observation. The average weight loss in 11 out of 15 rabbits in the hydrocortisone and medrysone groups was essentially the same while 10 out of 15 rabbits gained weight in the control group. Data were presented comparing the value of corneal swabbing and needle puncture for recovery of C. albicans from experimentally produced deep keratitis. Swabbing and needle puncture were more reliable diagnostic methods when the corneal infection had progressed to clinical hypopyon.