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November 1965


Author Affiliations

11811 Shaker Boulevard Cleveland 44120

Arch Ophthalmol. 1965;74(5):701. doi:10.1001/archopht.1965.00970040703025

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To the Editor:  A note of caution should be added to the article by Drs. Dohlman and Zucker on "Long-term Treatment with Idoxuridine and Steroids," (Arch Ophthal 74:172-174, 1965). Concomitant administration of topical antibiotics with idoxuridine and steroids may prevent secondary bacterial infections, but an additional risk is undertaken—that of secondary mycotic keratitis.I recently saw a 25-year-old landscaper with a left herpetic keratitis (with slight stromal involvement) and iritis. Treatment consisted of idoxuridine ointment and suspension of prednisolone acetate 0.5% with polymyxin B sulfate and neomycin sulfate five times a day, and atropine. By the seventh day the stroma was clear and the dendrite was almost gone; treatment was continued. Three days later a white corneal ulcer appeared at the site of the former dendrite. Two days later, the infection appeared typically mycotic. Scraping and culture revealed Cephalosporium. Previous medication was replaced with hourly instillations of amphotericin B. When

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