New Aspects in the Diagnosis and Therapy of Mycobacterial Keratitis

  • Darlene Miller
  • Dalia Girgis
  • Carol Karp
  • Eduardo C. Alfonso


Mycobacterial keratitis is a rare event [1]. In general, infection rates constitute less than 2% of reported infectious microbial keratitis cases [2, 3]. Rates may vary by geographical locations and have been as high as 8% in some reported series from Asia (Reddy, Lalthia, Huang). Trends in recovery of mycobacteria from keratitis increased in number and diversity of pathogens in the last decade (Fig. 1.1 and Table 1.1). Disease recognition, confirmation and management, however, remain challenging. Clinical diagnosis is problematic due to delay in presentation, low index of suspicion, mimicry of fungal or viral keratitis, and prior antibiotic and/or corticosteroid therapy. Traditional risk factors have included trauma with metal objects, soil and/or vegetable matter or following surgical interventions such as radial keratotomy, photorefractive keratectomy, cataract surgery, or contact lens wear (Fig. 1.2). Current and emerging risk factors are mainly health care related and include surgical procedures (LASIK, LASEK, DSEK), smart plugs, and other biomaterials (Fig. 1.3). In several patients, no identifiable risk factor has been documented [4–7].


Nontuberculous Mycobacterium Contact Lens Wear Mycobacterial Species Mycobacterium Species Deep Anterior Lamellar Keratoplasty 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Darlene Miller
    • 1
  • Dalia Girgis
    • 1
  • Carol Karp
    • 1
  • Eduardo C. Alfonso
    • 1
  1. 1.Department of OphthalmologyUniversity of Miami Miller School of MedicineMiamiUSA

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