EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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Editors' note: Dr. Bakewell has no financial interests related to this talk. Dr. Chang has financial interests with AMO. Drs. Osher and Lane have financial interests with Alcon and AMO. Is there a need for culture and susceptibility testing? The "Interactive Cornea" session brought up a number of cases and issues that doctors deal with today, as well as tips for approaching a variety of cornea problems. Edward Holland, M.D., Cincinnati, talked about culture and susceptibility testing and when it is necessary. For the majority of cases, Dr. Holland maintained that the testing often is not necessary. For most conjunctival infections, treatment can begin even before a firm diagnosis is made, Dr. Holland said. "There's good data that empiric treatment is efficacious," he said. Dr. Holland's presentation also concluded that for most presumed corneal infections, empiric treatment with fourth-generation fluoroquinolones is effective. He said that there is less concern about resistance with the fourthgeneration FQ and that there is also better coverage for methicillin-resistant Staphylococcus aureus (MRSA) as well. To further support his opinion for not culturing conjunctival infections, Dr. Holland brought up the issue of storage. "Storage is not very practical for the vast majority of practices," he said. Dr. Holland's conclusions indicated that culture and susceptibility testing rarely changes the management of the infections and that he would reserve it for those cases that have a high risk for non-bacterial or progressing severe infections. "Obviously there are caveats to not culturing," he said. Dr. Holland said he would definitely culture patients with a history of trauma where there is a likelihood of fungal keratitis or atypical bacteria. continued on page 144 Watch this video on your smartphone or iPad using your QR code reader. (Scanner available for free at your app store.)