Ten-Year Review of Pediatric Microbial Keratitis and Applicability of the 1-2-3- Rule

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Author Info

W. Walker Motley Wejdan Al-Thawabieh

Corresponding Author

W. Walker Motley
Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Abrahamson Pediatric Eye Institute, Cincinnati, Ohio, USA

A B S T R A C T

Purpose: To describe the current spectrum of bacterial etiologies, clinical features, medical management and visual outcomes of pediatric community-acquired bacterial keratitis and to evaluate the usefulness of the 1-2-3-Rule in predicting vision loss. Methods: A retrospective review was performed of consecutive cases of pediatric keratitis treated at a single institution over a 10-year period. The 1-2-3-Rule was applied retrospectively and analyzed to determine its accuracy in predicting vision loss. Results: Seventy-seven cases were identified. Pseudomonas was the most common organism identified followed by coagulase-negative staphylococcus and staphylococcus aureus. Only one case of staphylococcus aureus keratitis was methicillin resistant. Most (n=66) of the 74 verbal patients regained 20/30 or better visual acuity and 5 had final visual acuity of 20/100 or worse. The 1-2-3-Rule yielded high sensitivity and negative predictive values in our pediatric patients. Conclusions: Methicillin-resistant staphylococcus aureus (MRSA) is an infrequent pathogen in cases of pediatric community-acquired bacterial keratitis. Pseudomonas continues to be a common etiology. Most pediatric patients retain good visual acuity with treatment. When applied at a patient’s initial evaluation, the 1-2-3-Rule test may be helpful in predicting which pediatric patients will retain good visual acuity following treatment.

Article Info

Article Type

Review Article

Publication history

Received: Sat 11, Apr 2020
Accepted: Fri 24, Apr 2020
Published: Wed 29, Apr 2020

Copyright

© 2023 W. Walker Motley. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2020.04.11