To the Editor.
The article in the Archives titled "Corneal Perforation and Iris Prolapse due to Mima polymorphia" (93:239, 1975) was an interesting report, and Dr Wand and his co-workers have performed a service by recalling this entity to our attention. Nevertheless, I am distressed by some of the therapeutic measures discussed.The patient in question initially had a severe conjunctivitis with a purulent or mucopurulent discharge. Initial treatment consisted of sulfacetamide drops and erythromycin ointment. Sulfacetamide is bacteriostatic (or effectively bacteriocidal under certain circumstances) by virtue of its ability to prevent bacterial utilization of p-aminobenzoic acid (PABA). Bacteriostasis induced by sulfacetamide may be inhibited by the presence of PABA, according to the kinetics of competitive inhibition. Purulent exudate contains PABA, and therefore will interfere with the action of locally applied sulfacetamide. One might prefer to use an alternate medication in a conjunctivitis of this sort.Erythromycin ointment
Schechter RJ. Treatment of Mima polymorphia Conjunctivitis. Arch Ophthalmol. 1976;94(2):338-339. doi:10.1001/archopht.1976.03910030176020