This review article highlights the newer diagnostic modalities and approaches in the medical management of infectious
keratitis. A Medline literature search conducted to March 2014 has been included. Recent studies or publications were selected from international indexed journals using suitable key words. Development of specular microscopy and polymerase chain reaction (PCR) has a promising role as diagnostic modalities in infectious
keratitis, especially in refractory cases. Previously fortified
antibiotics have been the mainstay of treatment for bacterial
keratitis. Recently, the advent of fourth-generation
fluoroquinolones monotherapy has shown promising results in the management of bacterial
keratitis.
Corneal collagen cross-linking is being considered in the refractory cases. Topical
natamycin and
amphotericin B should be considered as the first choice
anti-fungal agents in suspected filamentous or yeast
infection respectively.
Voriconazole and newer routes of administration such as intrastromal and
intracameral injection of conventional
anti-fungal agents have demonstrated a positive clinical response.
Ganciclovir is a newer anti-viral agent with promising results in
herpes simplex keratitis. Thus, introduction of newer diagnostic modalities and
collagen cross-linking along with fourth-generation
fluoroquinolones and newer
azoles have a promising role in the management of infectious
keratitis.