Li Gavin, Shekhawat Nakul
The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 600 North Wolfe St, Baltimore, MD, 21237, USA.
Am J Ophthalmol Case Rep. 2022 Mar 25;26:101499. doi: 10.1016/j.ajoc.2022.101499. eCollection 2022 Jun.
To describe two cases of keratitis diagnosed and treated at the epithelial stage of disease and to underscore the importance of early diagnosis on prognosis.
Case 1 is a 28-year-old male who developed keratitis after prolonged contact lens wear. Case 2 is a 43-year-old male with poor contact lens hygiene who was initially misdiagnosed and treated for herpetic keratitis. Both cases presented with epitheliopathy and were successfully treated with corneal epithelial debridement and topical anti-amoebic therapy, with complete avoidance of deeper extension of infection and associated complications.
Epithelial stage keratitis represents a critical window of opportunity to achieve rapid cure. epitheliopathy may be mistaken for other conditions such as herpetic keratitis, contact lens overwear, or dry eye. Given worsening prognosis following delayed diagnosis, it is important for clinicians to be suspicious of keratitis in all contact lens wearers who develop elevated epitheliopathy.
描述两例在疾病上皮阶段被诊断和治疗的角膜炎病例，并强调早期诊断对预后的重要性。
病例1是一名28岁男性，长期佩戴隐形眼镜后发生角膜炎。病例2是一名43岁男性，隐形眼镜卫生习惯差，最初被误诊为疱疹性角膜炎并接受治疗。两例均表现为上皮病变，通过角膜上皮清创术和局部抗阿米巴治疗成功治愈，完全避免了感染的进一步扩展及相关并发症。
上皮阶段角膜炎是实现快速治愈的关键时机。上皮病变可能被误诊为其他病症，如疱疹性角膜炎、隐形眼镜佩戴过度或干眼症。鉴于延迟诊断会导致预后恶化，临床医生对所有发生上皮病变加重的隐形眼镜佩戴者怀疑患有角膜炎很重要。
