Distinguishing fungal and bacterial keratitis on clinical signs

Conclusion Management of microbial keratitis remains a major challenge worldwide, more so in lowand middle-income countries with inadequate health care resources. Although the outcome of treatment has improved significantly, many patients continue to deteriorate in spite of the best treatment that can be offered. The continued emergence of strains of microorganisms that are resistant to an ever-expanding range of antimicrobials poses an additional challenge. Further research related to prevention of microbial keratitis and enhancing host resistance are two worthwhile goals to pursue. Largescale public education programmes to alert those at risk of microbial keratitis, and to encourage earlier presentation, should be undertaken. Coupled with this, education of practitioners, general physicians, and other health workers, as well as general ophthalmologists, will go a long way towards ensuring correct diagnosis, appropriate treatment and timely referral before extensive damage to the cornea occurs. Several studies have indicated that the best way to prevent corneal ulcers in lowand middle-income countries is to treat corneal abrasions in the primary care setting within 48 hours of the injury.3-6 This could be adopted in any population and is cost-effective for both health providers and the patient.