[Ocular infection by Pseudomonas aeruginosa in a mechanically ventilated patient]

A 59-year-old man developed bilateral keratitis several weeks after the initiation of mechanical ventilation because of respiratory failure and sepsis following abdominal surgery. Colonisation of the upper airways by P. aeruginosa had been established before. Invasion through corneal epithelial defects based on dehydration keratitis was the presumed route of infection. Despite aggressive treatment, including antibiotics, the infection was rapidly progressive in both eyes. The patient died of deterioration of his general condition. In order to prevent such eye infections in a patient on mechanical ventilation, there is a need of good eye care, prevention of corneal lesions and alertness, especially when the patient is colonised by virulent micro-organisms like P. aeruginosa.

Corneal sensitivity in patients with leprosy and in controls

AIMS

In a quantitative prospective study the corneal sensation in patients with leprosy was compared with age matched controls.

METHODS

The patients with leprosy were classified as paucibacillary and multibacillary and were divided in three groups: (1) patients without clinically detectable eye pathology; (2) patients with lagophthalmos, (3) patients with signs of iridocyclitis. The corneal sensitivity was assessed with the Cochet and Bonnet aesthesiometer.

RESULTS

There was a significant decrease in corneal sensitivity in multibacillary patients without clinically detectable eye pathology and in patients with lagophthalmos or iritis when compared with controls. A significant correlation between the loss of power of the orbicularis oculi muscle and the degree of corneal sensation loss could not be established. No significant decrease in corneal sensitivity was found in paucibacillary patients without eye pathology compared with the control group.

CONCLUSION

The results of this study showed that loss of corneal sensation can occur while there is no clinically detectable eye pathology, at least in multibacillary patients. Regular checkups of the corneal sensation should, therefore, be part of the routine control of leprosy patients. Health education on eye care and early warning signs should be encouraged.