article = {SCR-2020-4-111}
title = {Ten-Year Review of Pediatric Microbial Keratitis and Applicability of the 1-2-3- Rule}
journal = {Surgical Case Reports}
year = {2020}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2020.04.11}
url = {https://www.sciencerepository.org/ten-year-review-of-pediatric-microbial-keratitis-and-applicability_SCR-2020-4-111 
author = {W. Walker Motley,Wejdan Al-Thawabieh,}
keywords = {Keratitis, corneal ulcer, pediatric, children}
abstract ={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.}