RESUMO
INTRODUCTION AND PURPOSE: We report a case of extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) scleritis after pterygium surgery. METHODS: Case report. RESULTS: A 58-year-old farmer presented with a 40-day history of severe pain, swelling, and blurred vision after a pterygium excision was performed at another institute. The patient was on multiple medications with no relief. The examination showed a nasally located scleral thinning in his right eye, with ulceration and infiltrates. Microbiology revealed Pseudomonas aeruginosa, which showed intermediate sensitivity to colistin only. The patient was administered topical (0.19%) and intravenous colistin and dexamethasone. There was a rapid reduction in symptoms, and the lesions healed over the next 2 months. CONCLUSIONS: To the best of our knowledge, this is the first case report of XDR-PA scleritis. We suggest the possibility of evolving drug resistance caused by the iatrogenic use of antibiotics during the early stages of the disease course.
RESUMO
In this case, a female teenager presented to the clinic with blurring of vision at a distance in both eyes since 2 years. All preliminary examinations were recorded. Retinoscopy revealed split reflex in both eyes. Both anterior and posterior segment findings seem to be within normal limits except for the microcornea. Topography depicts an asymmetric bow tie with superior steeping in both eyes. This case was diagnosed as pure microphthalmos associated with irregular corneal curvature, suggestive of keratoconus without corneal thinning with the help of topography and biometric measurements. Contact lens trial was advised to improve the visual potential. Fitting this patient in RGP lenses has been a challenging task because of narrow palpebral fissure height and small cornea.