The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Bacterial ulcer in a contact lens wearer

Photo by Professor Chua Chung Nen

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 with hypopyon.

 

Close-up view of the ulcer showing mucopurulent exudate with some corneal necrosis.

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