Ophthalmology · UKMLA & AKT

Bacterial keratitis

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise bacterial keratitis — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Topical steroid eye drops - suppress local corneal immune response, leaving epithelium vulnerable to bacterial invasion even by low-virulence organisms
  • Contact lens wear - especially extended-wear or overnight use; strongly associated with *Pseudomonas aeruginosa*
  • Pre-existing ocular surface disease - associated with *Staphylococcus aureus* keratitis in non-contact lens wearers

Patient on steroid eye drops for uveitis or allergic eye disease who develops a painful red eye with a corneal infiltrate - think bacterial keratitis until proven otherwise. Steroids remove corneal immune surveillance, creating an open door for bacteria.

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