Diagnosis of bacterial contact lens related keratitis with the white-light confocal microscope

Abstract

Purpose: We used white-light confocal microscopy to identify the causative organisms in two patients with contact lens related keratitis.

Methods: The corneal infiltrates were examined by confocal microscopy and corneal specimens were obtained for culture.

Results: In both patients, confocal microscopy revealed 1.5- to 2-micron diameter hyper-reflective bodies below the level of the epithelium. The sizes of these structures were consistent with those of bacteria. The corneal cultures from one patient grew Staphylococcus werneri and the cultures from the other patient grew Streptococcus viridans.

Conclusions: The confocal microscope permitted the in vivo observation of what we believe to be bacteria in patients diagnosed with contact lens related keratitis.