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February 1965

Topical Tigers

Arch Ophthalmol. 1965;73(2):153. doi:10.1001/archopht.1965.00970030155001

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In an age when so many external eye diseases respond favorably to one or more of the myriad medications at hand, ophthalmologists tend more and more to dispense with the tiresome and seemingly unnecessary intermediate steps leading to an etiologic diagnosis.

One of the interesting consequences of the empirical use of topical antibiotics is the belief, common to anxious therapists, that a patient whose minor irritation fails to respond to a favorite preparation must be treated with more powerful ones at more frequent intervals. Under no circumstances should antibiotics be stopped, it is reasoned, because hypothetical organisms, barely controlled by intensive treatment, would then appear in exuberant and devastating force! While our colleague (could it be ourselves?) is thus holding an imaginary tiger by the tail, his patient either fails to improve or develops an allergic reaction which is now mistaken for an exacerbation of the nonexistent bacterial infection. This

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