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Öğe A nationwide survey of prophylaxis against ophthalmia neonatorum in Turkey(Tubitak Scientific & Technological Research Council Turkey, 2009) Eser, Ilker; Bozaci, MeltemAim: To analyze the current practice of neonatal conjunctivitis (ophthalmia neonatorum) prophylaxis in Turkey. Materials and methods: A standard questionnaire that collected information regarding the name and location of the clinical setting, the name and dosage of the medication used to prevent neonatal conjunctivitis (if there was any), and the department and preference concerning which health workers should administer the agent (gynecologist, pediatrician, or midwife) was prepared and administered to 24 university hospitals as well as to 24 registered community hospitals that had both pediatric and obstetric units. Results: Neonatal conjunctivitis prophylaxis was administered by 58.3% of the respondents (university hospitals [66.7%] and community hospitals [50%]). The 2 most frequently used substances were gentamycin 18/28 (64.3%) and tobramycin 4/28 (8.3%). Other substances were tetracycline, silver nitrate, povidone-iodine, bacitracin + neomycin, and penicillin G. Conclusion: A nationwide consensus on the clinical department that should be involved, which health workers should administer the agent (gynecologist, pediatrician, or midwife), and which substance should be used for ophthalmia neonatorum prophylaxis must be reached. By using a similar survey other Countries may also assess their Current situation, and decrease the occurrence of neonatal conjunctivitis and neonatal blindness by administering the appropriate substances.Öğe ACUTE-ONSET ENDOPHTHALMITIS AFTER CATARACT SURGERY Success of Initial Therapy, Visual Outcomes, and Related Factors(Lippincott Williams & Wilkins, 2009) Altan, Tugrul; Acar, Nur; Kapran, Ziya; Unver, Yaprak Banu; Yurttaser, Serap; Kucuksumer, Yasar; Eser, IlkerPurpose: To evaluate the success of initial treatment and the factors influencing the outcome in acute-onset endophthalmitis after cataract surgery. Methods: We retrospectively reviewed the medical records of all patients with acute postoperative endophthalmitis between 2000 and 2007. We performed pars plana vitrectomy (PPV) to all eyes with initial visual acuity of light perception. Eyes with visual acuity of hand motions or better underwent either intraocular antibiotic injection (IOAI) or PPV. Eyes that did not give a good clinical response to initial therapy within 60 hours underwent a second procedure. The main outcome measure was the rate of early reintervention after PPV and IOAI. Results: We evaluated 88 eyes of 88 patients. Thirty-seven patients underwent PPV and 51 patients underwent IOAI alone. Six of 37 (16.2%) patients required 1 or more procedures within 60 hours of the initial procedure in the PPV group. Twenty-eight of 51 eyes (54.9%) in the IOAI group underwent PPV within 60 hours. The rate of response to primary PPV was significantly higher than to primary IOAI (P < 0.001). Gram-negative organisms composed 35.1% of the isolates. Conclusion: Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV. RETINA 29:606-612, 2009Öğe Assessment of Pupil Diameters of Emmetropes and Myopes under Photopic, Mesopic and Scotopic Conditions, Using the Infrared Pupillometer Integrated Within Schwind Sirius Multifunctional Diagnostic Device(Ortadogu Ad Pres & Publ Co, 2012) Taskiran Comez, Arzu; Komur, Baris; Eser, IlkerObjective: To assess the pupil diameters of emmetropes and myopes in photopic, mesopic and scotopic conditions. Material and Methods: Pupil diameters of 49 emmetropic subjects [spherical equivalent (SE) values +/- 0.25 diopter (D) with a mean age of 31.0 +/- 10.5 years (range 17 to 58 years)], and 61 age-matched (mean age 31.3 +/- 8.9 years, range 17 to 52 years) myopic subjects (SE values >=-1D) were measured with the infrared pupillometer integrated within Schwind Sirius Multifunctional diagnostic device (Eye-tech-solutions, Kleinostheim, Germany) in photopic (40 lux) condition simulating the day-time in mesopic (4 lux) condition and in scotopic (0.04 lux) condition simulating the level of light encountered at night. All statistical analyses were performed according to two-sided hypothesis tests and a p-value of less than 0.05 was considered statistically significant. Results: The mean photopic pupil diameter was 3.62 +/- 0.73 mm (range 2.49 to 5.83) in the emmetropic group and 3.86 +/- 0.85 mm (range 2.06 to 6.67) in the myopic group. The mean mesopic pupil diameters were 4.68 +/- 0.78 mm (range 3.19 to 6.45) and 5.16 +/- 0.91 mm (range 3.23 to 7.46) and the mean scotopic pupil diameters were 5.63 +/- 0.70 mm (range 4.28 to 7.14) and 6.08 +/- 0.86 mm (range 4.30 to 7.95) in emmetropes and myopes, respectively. The mean pupil diameters of myopes were larger than emmetropes in all three light conditions (p<0.001). There was no interaction between patient group and light condition (p>0.05). Conclusion: The mean pupil diameters of myopic subjects were larger than the pupil diameter of emmetropes. Pupil diameter should be measured objectively under standardized illumination levels in order to minimize the risk of post-operative glare and halo formation in refractive surgery patients.Öğe Association between ocular dominance and refraction(Slack Inc, 2008) Eser, Ilker; Durrie, Daniel S.; Schwendeman, Frank; Stahl, Jason E.PURPOSE: To investigate the association between ocular dominance and refraction. METHODS: A retrospective study of the cycloplegic refraction of 24,53 consecutive patients with a mean age of 46 12 years (range: 18 to 79 years) was performed. One thousand one hundred fifty-seven (47%) patients were men and 1296 (53%) were women. Patients who had previous eye surgery, ocular disease, or >2 lines of best spectacle-corrected visual acuity (BSCVA) difference between eyes were excluded. Motor ocular dominance was determined using the hole-in-the-card test. RESULTS: The right and left eyes were dominant in 67% (1650) and 33% (803) of patients, respectively. Males had a higher right eye dominance (70%) than females (65%) (P=.0168) with a mean cycloplegic spherical equivalent refracton (SE) of -2.12 diopters (D) and -2.38 D, respectively. This higher rate of right eye dominance in males was seen at all levels of SE refractive error. Mean BSCVA was 20/19 in both right and left eyes (P>.05) with a mean SE of -2.25 +/- 3.63 D and -2.26 +/- 3.66 D in the right and left eyes, respectively. Neither mean SE difference nor BSCVA difference between eyes was found to correlate with motor eye dominance. CONCLUSIONS: Gender appears to be a factor when testing ocular dominance but not SE refractive error. The hole-in-the-card dominance test is a method that is easy to perform for both patients and clinicians.Öğe Comparative outcomes of pars plana vitrectomy in acute postoperative endophthalmitis with 25-gauge and 20-gauge techniques(Springer Tokyo, 2009) Altan, Tugrul; Kapran, Ziya; Eser, Ilker; Acar, Nur; Uenver, Yaprak Banu; Yurttaser, SerapTo evaluate the safety and outcomes of 25-gauge pars plana vitrectomy (PPV) in the treatment of postoperative endophthalmitis and compare it with 20-gauge PPV. The medical records of all patients diagnosed with acute endophthalmitis following cataract surgery who underwent PPV between December 2000 and December 2007 were reviewed. Main outcome measures included final visual acuity (VA), additional interventions, and both intraoperative and postoperative complications. Records of 70 eyes of 70 patients with a condition diagnosed as postoperative endophthalmitis were evaluated. Fifty-eight eyes underwent 20-gauge PPV (group 1), and 12 eyes underwent 25-gauge PPV (group 2). Mean follow-up time for group 1 was 9.6 +/- 8.8 months, and for group 2, 7.9 +/- 12.7 months (P = 0.57). Median VA at presentation was hand motion in both groups. The differences between the two groups in frequencies of visual outcome levels of 20/800 and 20/100 were significant in favor of group 2 (20/800, P = 0.006; 20/100, P = 0.01). In group 2, fewer additional interventions were required, and postoperative complications tended to be less frequent. Twenty-five-gauge PPV seems to be safe and effective in the management of postoperative endophthalmitis. This sutureless technique may have some advantages over 20-gauge surgery, but controlled studies are needed to confirm the results.Öğe Conjunctivitis due to Neisseria sicca: A case report(Medknow Publications & Media Pvt Ltd, 2014) Eser, Ilker; Alper Akçalı; Tatman-Otkun, Muserref; Taskiran-Comez, ArzuWe report the first case, in Medline-based literature, of conjunctivitis caused by gram negative diplococcus, Neisseria sicca. Although it is not widely accepted as such, isolation from cultures of repeated eye swab samples suggests that N. sicca may be a pathogen in conjunctival infections. Positive culture for this organism should not be readily dismissed. Such conjunctivitis responded favorably to treatment with netilmicin eye drops.Öğe Do the Alterations in Eyelid and Conjunctival Flora Lead to Streptococcal Endophthalmitis in Glaucoma Patients?(Turkish Ophthalmological Soc, 2010) Eser, Ilker; Beskoc, Melike; Erdogan, Hawa; Nakipoglu, Yasar; Eren, Hakan; Aydin, Derya; Yilmaz, Omer F.Purpose: To compare the eyelid and conjunctival flora of glaucoma patients with normal subjects. Material and Method: One hundred and thirty-two eyes of 83 patients were assigned to 4 groups, consisting of 33 eyes each. Group 1 consisted of eyes which underwent trabeculectomy without need for postoperative antiglaucoma drops (AGD), group 2 consisted of eyes which needed to use AGD following the trabeculectomy, group 3 consisted of eyes which did not undergo trabeculectomy but used AGD, and group 4, the control group, consisted of healthy eyes. All AGD contained benzalkonium chloride (BAC) as a preservative. Results: A statistically significant difference was found between the group using AGD and the control group, regarding the number of coagulase-negative staphylococci isolated from eyelid specimens (p=0.03). Although the isolation rates of Streptococcus spp. and Haemophilus spp. were higher in groups 1, 2 and 3 than in the control group for the conjunctival specimens, the difference was not statistically significant (p=0.87, p=0.29, respectively). Discussion: Trabeculectomy together with long-term use of AGD, or long-term use of AGD with BAC itself, seemed to decrease the number of coagulase-negative Staphylococci and to increase the number of Streptococcus spp. and Haemophilus spp. in the eyelid and conjunctival flora of the control group. As Streptococcus spp. predominate in cases of delayed-onset bleb-associated endophthalmitis, by taking eyelid and conjunctiva specimens for culture at certain intervals, their eradication might be achieved and therefore, the potentially devastating endophthalmitis might be prevented.Öğe Intraocular gas application in the diagnosis and treatment of valsalva retiopathy in a case with premacular hemorrhage(2009) Pinarci, Eylem Yaman; Demirel, Berna; Karaman, Sevil; Eser, Ilker; Güngel, Hülya0.3 cc pure C3F8 gas was instilled intravitreally with the aim of pneumatic displacement in order to make a differential diagnosis for the Valsalva retinopathy and hemorrhage due to SMD to a 72 year old male patient who had scar tissue development due senile macular degeneration (SMD) in the left eye and had sudden decrease in visual acuity because of premacular hemorrhage in right eye. The physical examination performed the other day on the patient who had been laid down in the supine position for 24 hours, revealed the drainage of hemorrhage by ensuing posterior vitreus detachment and complete resolution of the premacular hemorrhage. This paper aims to report that the diagnosis can be established in premacular hemorrhage cases exhibiting diagnositc uncertainity, by posterior vitreus detachment developing as a result of pneumatic displacement and thus the treatment is instituted accordingly.Öğe Investigation of the Relationship Amongst Refraction, Keratometric and Pachymetric Measurements(Turkish Ophthalmological Soc, 2008) Eser, Ilker; Kaya, Vedat; Kucuksumer, Yasar; Yilmaz, Omer FarukPurpose: To investigate the relationship amongst refraction, central corneal thickness (CCT) and keratometric measurements. Methods: A retrospective study of the subjective refraction of 1022 eyes of 511 consecutive subjects who presented for refractive surgery evaluation was performed. Of the subjects, 241(48%) were male and 270(52%) were female. Mean age of male and female were 32.1 +/- 9 and 30.1 +/- 8.1 respectively. Javal Keratometer was used for keratometric measurements. CCT was obtained with DGH 4000B A-Scan/Pachymeter. The statistical forecasting methods used are Mann-Whitney U-test, Spearman Correlation, Wilcoxon signed rank test, Kruskal-Wallis methods as implemented in the software package SPSS version 11.5. A p-value of <0.05 was considered to be statistically significant. Results: The relation between the age of the patients and CCT, and keratometric measurements were not statistically significant (p=0.598, p=0.403) respectively. While CCT were higher in male (p=0.002), keratometric values were higher in female (p=0.0001). Spherical equivalent (SE) showed a correlation with CCT values (p=0.04), and a negative lineer correlation with the keratometric values (p=0.0001). While females were found to be more myopic, males were more hyperopic (p=0.0001). CCT were higher in the eyes those >+5.00 Diopter(D) (p=0.04), and keratometric values were higher in the eyes those less than -6.00 D (p=0.0001). Conclusions: Males had lower keratometric measurements and were more likely to be hyperopic or mix hyperopic astigmatism than female. Females were more mix myopic astigmatism than males. CCT was higher in high hyperops and low in high myopes. A negative linear correlation between the keratometric measurements and SE was found. We believe that, investigation of these parameters would be helpful in better understanding of the biometric characteristics of the eye and choosing the appropriate technique in refractive surgery.Öğe Is Normative Database of Optical Coherence Tomography Device Comprise Turkish Population(Turkish Ophthalmological Soc, 2009) Eser, Ilker; Komur, Baris; Comez, Arzu TaskiranPurpose: To compare the retinal nerve fiber layer (RNFL) thickness normative values measured by Optical Coherence Tomography(OCT) with healthy subjects. Methods: Thirty-nine randomized right or left eyes of 39 healthy subjects(18 female, 21 male), with a mean age of 25.1 +/- 3.0(19-29) years were included in the study. Subjects without family history of glaucoma and who were evaluated by intraocular pressure(IOP) measurements, central corneal thickness(CCT), cup/disc ratio and OCT measurement results, and who were accepted as not in risky group for glaucoma were included in the study. Three sequential measurements were taken by Spectral OCT/SLO [Opko/OTI, Inc., Miami, FL] analyzer, by the same operator in the same day, and mean of these 3 measurements was used for the analysis. One sample t-test was used for statistical analysis. Results: The mean values of the subjects and the normative RNFL thickness database used by the device were; 142.5 +/- 16.5 mu and 134.4 +/- 17.0 mu(p=0.004) in the superior quadrant, 97.4 +/- 11.5 mu and 90.2 +/- 15.3 mu (p=0.0001) in the nasal quadrant, 145.4 +/- 16.3 mu and 136.75 +/- 16.0 mu(p=0.002) in the inferior quadrant and 73.6 +/- 8.6 mu and 74.3 +/- 13.0 mu(p=0.659) in the temporal quadrant, respectively. There was 6.1-8% RNFL thickness difference between the values measured in the superior, nasal and inferior quadrants and the normative data used by the device; while compatibility of the values between temporal quadrants and normative data was obtained. Conclusion: The RNFL thickness in the superior, nasal and inferior quadrants were found to be statistically significant thicker in subjects included in the study. If the lower normative database used by the device were taken into account, errors in early diagnosis and the treatment of glaucoma would be inevitable. The initial data of our continuing study, reveal that the RNFL thickness values in healthy subjects of our population might not be plug-compatible with the normative database used by the device and this may result in a need to develop Turkish normative database.Öğe Is Single Measurement Enough to Get a Reliable Result with Optical Coherence Tomography?(Turkish Ophthalmological Soc, 2012) Comez, Arzu Taskiran; Eser, Ilker; Bakar, Coskun; Komur, BarisPurpose: To evaluate the repeatability and reliability of retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT). Material and Method: Two hundred sixty-six eyes of 135 subjects (glaucoma, glaucoma suspects and healthy) were included in this study. Three sequential inferior, superior, nasal and temporal RNFL thickness measurements were performed using Spectral OCT [Opko/OTI, Inc., Miami, FL] by one operator at one session without pupillary dilatation. The differences between these three measurements of each quadrant in each eye were compared in microns and percentages. Repeated measures analysis of variance was performed for statistical analysis. Reliability is measured by intraclass correlation coefficient (ICC) for each quadrant. Results: ICCs of all quadrants ranged between 0.77 and 0.92, with the measurements of nasal quadrant being the least reproducible and the inferior being the most reproducible of all quadrants. RNFL measurement errors over 20% were seen in 9.63% of nasal quadrant, 5.3% of temporal quadrant, 0.6% of superior quadrant and only 0.3% of inferior quadrant measurements. Discussion: In order to get more repeatable and reliable results with OCT, sequential measurements more than one should be considered. We believe that special attention is required in the analysis of data of nasal and temporal quadrants.Öğe Isolates and antibiotic sensitivity of eighty culture-proven endophthalmitis cases from Istanbul(Karger, 2008) Eser, Ilker; Kapran, Ziya; Altan, Tugrul; Karatas, Meltem Ozel; Aydin, Derya; Okaygun, Eda; Yilmaz, Omer FarukPurpose: To investigate the spectrum of organisms causing endophthalmitis and their sensitivity to commonly used antimicrobial agents. Methods: Medical records of 80 consecutive patients treated at Beyoglu Eye Hospital for endophthalmitis from January 2001 to April 2006 were reviewed. Specimens were obtained from either the vitreous (93%, 81/87) or anterior chamber (7%, 6/87) during pars plana vitrectomy or vitreous tap, and were inoculated into blood culture bottles. A Kirby-Bauer disk diffusion test was performed to determine antibiotic susceptibility. The outcome measures included isolates identified and antibiotic sensitivity of the specimens. Results: Fifty-six of 87 (64.4%) isolates were Gram-positive organisms, 29 (33.3%) were Gram-negative organisms, and 2 (2.3%) were fungi. The most common organism group identified was coagulase-negative staphylococci in 26.4% (23/87). While vancomycin was active against all Gram-positive isolates tested (100%), ceftazidime had the highest susceptibility rate (100%) for Gram-negative organisms isolated. Conclusions: Although coagulase-negative micrococci predominated in this series, a high isolation rate for Gram-negative organisms was obtained. High susceptibility rates for ofloxacin make it an alternative to ceftazidime and vancomycin in both Gram-negative- and Gram-positive-derived endophthalmitis, respectively. Studies with larger series and additional antibiotics are needed to confirm these findings. Copyright (C) 2008 S. Karger AG, Basel.Öğe Kill rates of preserved and preservative-free topical 8-methoxy fluoroquinolones against various strains of Staphylococcus(Elsevier Science Inc, 2009) Hyon, Joon Young; Eser, Ilker; O'Brien, Terrence P.PURPOSE: To assess the kill rates of preserved and preservative-free 8-methoxy fluoroquinolones and benzalkonium chloride (BAC) against isolates of Staphylococcus aureus and coagulase-negative Staphylococcus (CNS) species. SETTING: Bascom Palmer Eye Institute, Miami, Florida, USA. METHODS: Ocular and standard isolates of S aureus and CNS were inoculated with saline, 0.005% BAC, gatifloxacin 0.3% containing 0.005% BAC (Zymar), or BAC-free moxifloxacin 0.5% (Vigamox) at 37 degrees C. Bacterial viability was assessed after 15 minutes, 30 minutes, and 60 minutes. RESULTS: Thirteen isolates of S aureus and 5 isolates of CNS were used. The mean initial load of bacterial inoculum was 5.45 log colony-forming units (CFU)/mL +/- 0.37 (SD). Saline did not affect the density of staphylococci; BAC significantly decreased the staphylococci count to a mean of 3.80 +/- 0.32 log CFU/mL at 60 minutes (P<.05). Gatifloxacin 0.3% reduced the number of staphylococci significantly more than moxifloxacin 0.5% at 15 minutes (mean 0.47 +/- 1.12 log CFU/mL versus 4.55 +/- 0.60 log CFU/mL), 30 minutes (mean 0.07 +/- 0.31 log CFU/mL versus 3.82 +/- 1.07 log CFU/mL), and 60 minutes (mean 0.00 +/- 0.00 log CFU/mL versus 2.75 +/- 1.29 log CFU/mL) (P<.005). Gatifloxacin 0.3% completely eradicated most S aureus (10/13) and CNS (3/5) isolates at 15 minutes; moxifloxacin 0.5% did not achieve complete kill in any S aureus isolate (13/13) or in most CNS isolates (4/5) at 60 minutes. CONCLUSION: The commercial formulation of gatifloxacin 0.3% containing BAC 0.005% completely eradicated staphylococcal isolates more rapidly than the BAC-free formulation of moxifloxacin 0.5% or BAC 0.005% alone.Öğe Phakic anterior chamber lenses in very high myopia: an 18-month follow up(Wiley-Blackwell, 2012) Akcay, Levent; Eser, Ilker; Kaplan, Aysin T.; Taskiran-Comez, Arzu; Dogan, Omer K.Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Design: A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. Participants: Sixty-two eyes of 31 patients received iris-claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle-supported lens (group 2) (I-Care, Corneal). Methods: The mean preoperative spherical equivalents for group 1 and group 2 were -12.13 D and -18.95 D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18 months for follow ups. Main Outcome Measures: Percentage change in endothelial cell density and improvement in visual acuity. Results: At the 18-months follow up, uncorrected visual acuity improved to logMAR 0.37 +/- 0.23 from 1.60 +/- 0.10 in group 1, and logMAR 0.47 +/- 0.14 from 0.70 +/- 0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23 +/- 0.22 from logMAR 0.36 +/- 0.14) in group 1, and logMAR 0.29 +/- 0.18 from logMAR 0.50 +/- 0.20) in group 2 (P < 0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm(2) (8.61%) and 223 cells/mm(2) (8.42%) at 18 months follow up in group 1 and 2, respectively (P = 0.17) but significant in comparison to preoperative values for both groups (P < 0.001). Conclusions: Although both iris-claw and angle-supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18 months follow up.Öğe The Isolates in Endophthalmitis Cases Following Cataract Surgeries(Turkish Ophthalmological Soc, 2008) Altan, Tugrul; Acar, Nur; Unver, Yaprak Banu; Eser, Ilker; Kapran, ZiyaPurpose: To investigate the isolates of endophthalmitis cases following cataract surgeries in a single institute. Methods: Twenty eyes of 20 patients who had the diagnosis of endophthalmitis following cataract surgeries in Beyoglu Eye Training and Research Hospital were included to the study. Mean age was 68.6 +/- 11.8 years (40-82) and 12 of them (60%) were male and 8 of them (40%) were female. Vitreous samples were sent to the laboratory for microbiological analysis in the syringe without inoculating (1 case) or after inoculation into blood culture bottles (19 cases). Results: While 16 of 19 (84.2%) blood culture bottles yielded positive, 3 of 19 remained sterile. The sample which was sent in the syringe remained sterile. Overall, 11 of 18 (61%) isolates were gram positive cocci, 7 isolates (39%) were gram-negative organisms. Two specimens yielded mixed flora (2 bacteria each). The most frequently isolated bacteria were Staphylococcus aureus (5 in 18) and Pseudomonas aureginosa (5 in 18). Conclusion: Culturing vitreous specimens with blood culture bottles may be an alternative to conventional culture media with a high yield positive rate especially in clinics which are unable to have adequate microbiology laboratory facilities. Although gram positive organisms were the most common pathogens in our series, gram negative agents were more frequent than in the literature. We think that breaks in the sterilization chain occurs more frequently in our country and this issue should be adressed more carefully.Öğe Tuberculosis of The Sclera(Turkish Ophthalmological Soc, 2008) Eser, Ilker; Ucan, Gamze; Yazici, Bulent; Adim, Saduman BalabanA 53-year-old female patient who presented with an inflamated scleral mass was diagnosed as scleral tuberculosis as a result of histopathologic evaluation. Systemic evaluation showed no evidence of tuberculosis. The patient received a multi-drug anti-tuberculosis treatment for 9 months. After treatment, all ocular symptoms improved and no recurrence occurred in the 22 months following the treatment. Scleral tuberculoma should be considered in patients presented with an inflammated mass in the sclera. In some cases, histopathological findings and positive response to the medical treatment may be sufficient for the diagnosis.Öğe What Should be the Antibiotic Preference in the Treatment of Bacterial Conjunctivitis?(Galenos Publ House, 2010) Eser, Ilker; Alcali, Alper; Comez, Arzu Taskuran; Komur, Bans; Ozbey, Nilgun; Otkun, Muserref TatmanPurpose: To investigate the pathogens associated with bacterial conjunctivitis and the in vitro antibiotic sensitivities of these bacteria. Material and Method: Forty-seven (27 female, 20 male) patients with a mean age of 43.7 26.4 (range: 1-84) years, who referred to our out-patient clinic with complaints of burning sensation, stringy discharge and hyperemia between December 2008 and March 2010, who were diagnosed with acute bacterial conjunctivitis, and had no history of any systemic or topical antibiotic use were induded in the study. Samples were taken from both eyes using cotton swabs, cultured onto chocolate and blood agar, and prepared for Gram staining. The identification of organisms was performed by Vitek2 compact system (bioMerieux, France). Antibiograms were evaluated according to the Clinical and Laboratory Standards Institute (CLSI) criteria by disc diffusion method. Results: Twenty-nine of 47 (61.7%) samples were culture-positive. The most common isolated bacteria were coagulasenegative staphylococci (16 cases, 55%). For them, the most sensitive antibiotics, given in decreasing order, were as follows: vancomycin (100%, 21/21), netilmicin (95.7%, 22/23), chloramphenicol (92.6%, 25/27) and tobramycin (91.3%, 21/23). Fluoroquinolones were relatively less sensitive: ofloxacin (75%, 21/28), moxifloxadn (75%, 18/24), dprofloxacin (73.1 %, 19/26). Discussion: Netilmidn, chloramphenicol and tobramydn were found to be more sensitive compared to fluoroquinolones in the treatment of bacterial conjunctivitis. Using these antibiotics as an empirical treatment, taking conjunctival culture of particular cases prior to treatment, and antibiotic switching according to antibiogram will be the most reasonable approach in case of no response to treatment.
