We report a patient of unilateral posterior keratoconus with systemic associations, second such case in the literature.

This is the largest case series on posterior keratoconus, depicting its varied features. Diagnosis of this uncommon condition requires a high index of suspicion, meticulous slit-lamp examination, and systemic evaluation to rule out other associated anomalies. We report a patient of unilateral posterior keratoconus with systemic associations, second such case in the literature.

To evaluate the reliability of manual annotation when quantifying cornea anatomical and microbial keratitis (MK) morphological features on slit-lamp photography (SLP) images.

Prospectively enrolled patients with MK underwent SLP at initial encounter at 2 academic eye hospitals. Patients who presented with an epithelial defect (ED) were eligible for analysis. selleck chemicals llc Features, which included ED, corneal limbus (L), pupil (P), stromal infiltrate (SI), white blood cell (WBC) infiltration at the SI edge, and hypopyon (H), were annotated independently by 2 physicians on SLP images. Intraclass correlation coefficients (ICCs) were applied for reliability assessment; dice similarity coefficients (DSCs) were used to investigate the area overlap between readers.

Seventy-five MK patients with an ED received SLP. DSCs indicate good to fair annotation overlap between graders (L = 0.97, P = 0.80, ED = 0.94, SI = 0.82, H = 0.82, WBC = 0.83) and between repeat annotations by the same grader (L = 0.97, P = 0.81, ED = 0.94, SI =ay include using multiple annotators per image or automated annotation software.

To provide a normative database of several Pentacam parameters for a healthy pediatric population.

This was a retrospective study conducted at Al Watany Eye Hospitals, Cairo, Egypt. We explored the Pentacam HR database and collected the data of 432 normal right eyes of children and teenagers aged 3 to 18 years. The subjects were classified into the following 3 groups group 1 (3-6 years, 17 eyes), group 2 (6-12 years, 126 eyes), and group 3 (12-18 years, 289 eyes). The parameters of the study cohort were compared with those of a healthy adult cohort.

The mean age of the study cohort was 13.5 (13.2-13.8) years. There were significant differences in the following indices among the 3 age groups anterior chamber (depth and volume), curvature (index of height decentration, index of vertical asymmetry, and center keratoconus index), elevation (front and back elevations from the best fit toric ellipsoid), and pachymetric (minimum and average pachymetric progression indices and average Ambrosio relational thickness) parameters (P values 0.001, 0.001, 0.002, 0.04, <0.001, <0.001, 0.03, 0.02, 0.01, and 0.03, respectively).

There were significant differences in the normative values of several Pentacam indices between the pediatric and adult cohorts. Based on this finding, it is more credible to incorporate separate software cutoff values for pediatric patients. However, because there were no clinically significant differences in the parameters of the pediatric subgroups, there is no need to consider a separate cutoff value for each pediatric age range.

There were significant differences in the normative values of several Pentacam indices between the pediatric and adult cohorts. Based on this finding, it is more credible to incorporate separate software cutoff values for pediatric patients. However, because there were no clinically significant differences in the parameters of the pediatric subgroups, there is no need to consider a separate cutoff value for each pediatric age range.

To report the outcomes of using scleral contact lenses as antibiotic reservoirs as a therapeutic approach in a case series of severe infectious keratitis and to discuss the clinical potential.

This was a prospective consecutive case series study of 12 eyes treated for infectious keratitis at the “Conde de Valenciana” Institute of Ophthalmology. A scleral lens (SL) filled with 0.5% moxifloxacin was used as a reservoir and replaced every 24 hours until epithelization was complete or the culture report and/or antibiogram demonstrated either a microorganism not susceptible to or resistant to moxifloxacin.

The study included 12 eyes of 12 patients (7 women; 58.33%; average age of 63 ± 20.11 years). All patients completed at least 1 month of follow-up. Patients had a diagnosis of infectious keratitis, and the SL was fitted on initial consultation. Of the 12 eyes, 7 had culture-positive bacterial infection, 2 eyes were mycotic, and 3 eyes had no culture growth. In 3 eyes, SL was discontinued because of the lack of response (one eye) and to the presence of mycotic infection (2 eyes). All infections resolved favorably at the final follow-up.

The use of SLs could be an alternative for antibiotic impregnation and treatment of infectious keratitis. No complications or side effects were observed related to the use of the scleral contact lens as a reservoir for the antibiotic. This treatment modality could offer a comfortable treatment for the patient, ensuring good impregnation and maintenance of antibiotic concentrations during the 24-hour wear periods.

The use of SLs could be an alternative for antibiotic impregnation and treatment of infectious keratitis. No complications or side effects were observed related to the use of the scleral contact lens as a reservoir for the antibiotic. This treatment modality could offer a comfortable treatment for the patient, ensuring good impregnation and maintenance of antibiotic concentrations during the 24-hour wear periods.

To characterize the risk factors, clinical presentations, management choices, and outcomes of Proteus mirabilis keratitis.

In this retrospective study, 26 culture-proven cases of P. mirabilis infections were diagnosed and treated between 1998 and 2019 at the University of Pittsburgh Medical Center. Medical records were available for 14 keratitis cases and were reviewed for demographic information, ocular risk factors, and treatment outcomes.

Sixteen eyes of 14 patients were included in the study. The average age was 47.8 ± 19.3 years, with a median follow-up time of 6 months. The most common ocular risk factors were poor ocular surface and contact lens use in 57.1% and 42.9% of cases, respectively. Eleven of the 14 patients (78.6%) had positive corneal cultures, and 13 of the 14 patients (92.9%) had positive conjunctiva or eyelid cultures. All isolates were susceptible to ciprofloxacin, ofloxacin, moxifloxacin, gatifloxacin, and cefazolin. Surgical intervention was required in 4 patients (28.6%). Average LogMAR visual acuity was 1.