Contact lens wear is associated with an increased risk of infectious keratitis that may present with atypical signs. We describe a case of Streptococcus viridans keratitis presenting as a small epithelial defect.
Report of a Case.
—A 64-year-old white woman was referred for evaluation of a corneal abrasion. She was wearing daily-wear soft contact lenses and described a 2-day history of a gritty and irritated right eye. On examination, her corrected visual acuity was 20/30+ OD and 20/25+ OS. There was trace hyperemia of the superior bulbar conjunctiva. The right cornea had a 1-mm epithelial defect at the 10-o'clock position 2 mm from the limbus. There was no stromal infiltrate and the anterior chamber was quiet. Scrapings of the defect with a sterile Kimura spatula were plated on blood agar, and tobramycin therapy (3 mg/mL every hour) was initiated. Heavy growth of S viridans sensitive to cefazolin was noted on
Nauheim RC, Nauheim JS. Contact Lens-Related Streptococcus viridans Keratitis Presenting as an Epithelial Defect. Arch Ophthalmol. 1991;109(10):1354. doi:10.1001/archopht.1991.01080100034021
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