This 30 year-old woman was
a contact lens wearer. She developed a painful left eye a week ago and was
treated with topical chloramphenicol at the polyclinic. Despite taking the
eyedrop religiously, the pain and the vision worsened. Slit-lamp examination
showed mucopurulent exudate on the cornea with necrosis and hypopyon.
Corneal scrap was performed for culture and sensitive and the patient was
admitted for intensive topical gentamicin and cefuroxime. She responded well
and was discharged after five days with 2hourly topical oxfloxacin.
The culture grew
Pseudomonas aeurginosa. This organism is the most common cause of
bacterial ulcer amongst contact lens user. The organism is sensitive to
gentamicin and quinolone but resistant to chloramphenicol.
Mucopurulent exudate on the cornea
Close-up view of the ulcer showing
mucopurulent exudate with some corneal necrosis.