Does identification of the causal organism of corneal ulcers influence the outcome?

Purpose: To investigate whether identification of the causal organism in corneal ulcers influences their outcome.

Methods: We retrospectively studied 114 patients, 72 males and 42 females aged 6-89 years, admitted to this eye clinic during the years 1994-2000 on account of an infectious corneal ulcer. Their examination included a detailed history, visual acuity measurement, and biomicroscopy in everyday follow-up. The ulcers were classified according to their severity and outcome. We assessed the cases where cultures had been done, reviewed the results, and searched for a possible correlation between the outcome and the fact of culturing the ulcer and identifying the causal organism.

Results: Of the 114 corneal ulcers studied, 23 were mild, 49 moderate, and 42 severe. Fifty (44%) had not been cultured, but 64 ulcers (56%) had been cultured, with a positive result in 37 cases (58%), Staphylococcus and Pseudomonas species being the most common organisms found. In moderate and severe ulcers, there was a tendency to a higher proportion of successful outcome for cultured ulcers, but with no significant correlation.

Conclusions: Despite a tendency towards favorable results in culture-positive corneal ulcers, the influence of the detection of the organism on their outcome has not been proved. The role of the initial broad-spectrum antibiotic therapy remains important.