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http://www.revoptom.com/content/c/20600/
VOLUME 2, NUMBER 18
SEPTEMBER 5, 2011

WHEN SHOULD YOU CULTURE AN INFECTIOUS KERATITIS?
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When deciding whether to culture a corneal ulcer, be sure to follow the "1, 2, 3 Rule." This specific guideline advocates the culturing of:
  • Any ulcer within 1mm of the visual axis (involving the central 5mm to 6mm of the cornea).
  • Any presentation with 2 or more infiltrates, because this could be indicative of satellite lesions in a potential fungal keratitis or simply an aggressive bacterial keratitis with multiple central infiltrates.
  • Any ulcer that is 3mm in size or larger.
Additionally, you may wish to consider culturing when you see:
  • Non-responsive keratitis.
  • Patients who are immunocompromised.
  • Patients who develop a corneal ulcer secondary to trauma.
  • Patients who have undergone a recent surgery.
  • Atypical presentations, such as a keratitis with a hypopyon.
  • Patients who present with an infection that was likely acquired in a hospital setting.
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