Comparison of bacterial culture results collected via direct corneal ulcer vs conjunctival fornix sampling in canine eyes with presumed bacterial ulcerative keratitis.

OBJECTIVE: To compare aerobic bacterial culture results between samples obtained from the corneal ulcer versus lower conjunctival fornix in eyes with presumed bacterial ulcerative keratitis. ANIMALS STUDIED: Fifty five client-owned dogs diagnosed with ulcerative keratitis. PROCEDURES: Ophthalmic examinations were performed on each dog including slit-lamp biomicroscopy and indirect ophthalmoscopy. Microbial swabs were collected by direct sampling of the infected corneal ulcer as well as the lower conjunctival fornix, of the same eye, using a sterile rayon-tipped swab. Samples were submitted to an outside reference laboratory for aerobic bacterial culture and sensitivity. RESULTS: One hundred twelve samples were obtained from 56 eyes (55 dogs). Sixty-eight samples yielded bacterial growth. Positive growth from both sites was obtained in 31 eyes (55%). Six eyes yielded bacterial growth from the conjunctival fornix but not from the cornea. No bacterial growth was obtained from either sampling site in 19 eyes. Overall, 31/56 (55%) corneal samples were positive and 37/56 (66%) conjunctival fornix samples were positive. Comparison of organisms isolated from the two collection sites of the same eye revealed an exact correlation in 42/56 (75%) eyes and differed in 14/56 (25%) eyes. Twenty different bacterial isolates were obtained from 68 positive samples. Gram-positive (71%) organisms were more common than Gram-negative (29%). The most commonly isolated organisms were Staphylococcus pseudintermedius (25%), beta-hemolytic Streptococcus spp. (23%), and Pseudomonas aeruginosa (12%). Methicillin-resistant organisms were isolated in 9% of samples. CONCLUSION: Sampling from the conjunctival fornix may be a suitable alternative to direct ulcer sampling in eyes with compromised corneal structural integrity.

Corneal anesthetic effect and ocular tolerance of 3.5% lidocaine gel in comparison with 0.5% aqueous proparacaine and 0.5% viscous tetracaine in normal canines.

OBJECTIVE: To compare the degree and duration of corneal anesthesia of a novel viscous ophthalmic lidocaine hydrochloride preparation vs. two commonly used ophthalmic anesthetic preparations. METHODS: Each subject was randomly selected to receive 2 of 4 treatments at 2 different time periods separated by a 1 week washout: 3.5% lidocaine hydrochloride gel (Akten® ; Akorn Inc., Lake Forest, Illinois, USA), 0.5% aqueous proparacaine hydrochloride (Akorn Inc.), 0.5% viscous tetracaine hydrochloride (TetraVisc™; Ocusoft Inc., Richmond, Texas, USA), or 0.9% saline eyewash as a negative control. Corneal sensitivity was determined using a Cochet-Bonnet aesthesiometer (Luneau® , Chartres Cedex, France) prior to instillation of each treatment; at 1 and 5 min post treatment; and at 5-min intervals thereafter for 90 min total. Ocular side effects were recorded on a scale of 0-3. RESULTS: Twenty-four normal dogs (48 eyes) were entered into the study. Mean duration of maximal anesthesia was significantly greater at 34.2 min with tetracaine compared to 21.5 min and 19 min with proparacaine and lidocaine respectively. Corneal sensitivity was significantly decreased from baseline for up to 70 min with tetracaine and 55 min with both proparacaine and lidocaine. All lidocaine-treated eyes had transient blepharospasm and conjunctival hyperemia. Ten out of 24 tetracaine-treated eyes had conjunctival hyperemia with 4 of these having concurrent chemosis. CONCLUSIONS: Tetracaine provided a significantly longer duration of corneal anesthesia than proparacaine or lidocaine. Tetracaine and lidocaine were associated with more ocular side effects than proparacaine, although these were mild and transient. None.