Chronic Ocular Hypertension after Treated Multifocal Bacterial Keratitis

PURPOSE To report an unusual case of multifocal bacterial keratitis that despite success-ful treatment caused chronic ocular hypertension. METHODS A 67-year-old woman with unilateral multifocal keratitis and no previous ocular pathology was admitted to our hospital. Corneal scrapings and conjunctival samples were obtained for culture and the patient received intensive therapy with fortified vancomycin and tobramycin eye drops. RESULTS The cultures demonstrated two strains of Staphylococcus epidermidis, one resistant to ciprofloxacin and both sensitive to vancomycin. Treatment was effective and gradually discontinued after total cessation of the inflammatory activity. During the follow-up period, the patient developed late and persistent ocular hypertension of unknown etiology, in absence of any detectable inflammation or complication, and received permanent antiglaucoma therapy. CONCLUSION Differential diagnosis between fungal and bacterial infection is critical in cases of multifocal keratitis. Patients with multifocal bacterial keratitis may need intraocular pressure monitoring, even after complete infection healing.