UK Keratoconus Self-Help and Support Association

Hi, I'd say for around 2 months now my right non transplanted eye has had a bacterial eye infection. I've applied chloramphenicol daily for around a month and although my lens specialist said its continuing to improve, the small amount of staining will not clear. It is preventing me from wearing a lens comfortably in that eye and as my left eye is not great at all (waiting for a better lens setup) it is inconvenient. My eye is not red, swollen or anything like that, all I have is moderate-severe dryness and a slight gritty feeling. I feel this doesn't warrant a visit to the cornea specialist at the hospital, but I doubt an optician would be able to help? Is there anything stronger I should be trying?

Thanks for reading.

Hi there Saffron

Chloramphenicol is the treatment of choice for a bacterial infection. There's not much more effective available. A typical course would be for 5 days, perhaps continuing to 10 days for a stubborn infection. So after four weeks, it becomes a possibility that it's not in fact a bacterial infection (otherwise it might have responded better to the Chloramphenicol). It could be a viral infection of the cornea. Then there's other really nasty things like Acanthamoeba that don't readily respond to externally-applied treatments. You could go on and on listing things which it could be. Generally speaking, any condition which a) isn't responding to a course of treatment b) has longevity and c) impacts your quality of life should not be ignored. Your lens specialist may well be right and would certainly be adept at identifying problems, but if you're concerned, then no-one is going to think ill of you for getting a second opinion.

If you're worried, then a visit to the eye unit at the hospital will either reassure you (and they really won't mind if it is a false alarm) or else get your diagnosis confirmed (and then you'll know that keeping on with the Chloramphenicol is the right thing to do) or else get you a different diagnosis and different treatment. So to cut a long explanation short, you can't loose. Ask to see the duty eye specialist rather than a generalist if possible.

Do let us know how you get on, try not to worry, but I can guarantee you that you'll feel a whole lot better for having got it checked out. If they moan at you for worrying over nothing, just blame it on me and tell them I said you should go.

Best wishes

Chris

Hi Chris, thanks for your advice.

I am worrying that this extended use of the chloramphenicol drops isn't good at all (the bottle specifically says do not go exceed 5 days, already gone through 1 tube of ointment). I just do not believe that this is a simple infection, and when it was first discovered my specialist exclaimed how they have never seen the particular pattern of staining that my right eye had. They then saw me back at the hospital two days later and didn't seem too concerned, said it had practically all cleared up and to carry on with the drops.

I last had it checked at my lens fitting 2 weeks ago & the lamp had to be turned up very bright to see the little bit left so I'm just hoping it doesn't go ignored. I will definitely be trying to bring forward the appointment with my cornea specialist very soon and let you know.

following my transplant in my right eye I had a infectionf or a solid 11 and a half months which only shifted eventually with both IV anti biotics and special anti biotics which have a life span of 12 horus n once opend must be used within 12 hours every half hour n kept in the fridge - was a total night mare.

so I can empathyse with stuborn infection, dont loose heart it will shift, it is not worth risking a lens as you could end up doing more damage than good.

There are plenty options other than chloramphenical , please see your specialist x

Hi Saffron
Don't worry about the bottle saying do not use for more than five days, that is a legal licensing restriction that applies when the sale is made by a pharmacist to the public, because after five days without resolution a doctor needs to take a look, make sure nothing is untowards, two months seems rather a long duration so a second opinion sounds good, but doing as the doctor says is ok. Just make sure you don't use the same bottle for more than 28days as sterility is compromised. There are other antibiotic eye drops available, the reason why chloramphenicol is chosen first is because it acts against two main types of bacteria whereas the others are more selective and it is hard to tell which type of bacteria we have in our eye.

Just to add... while Chloramphenicol is generally well tolerated, it isn't without some toxicity. If you do end up on a long term course e.g. more than a month, do pay particular attention to the possible side effects listed in the Patient Information leaflet which should have accompanied the medicine. Be aware of any unexplained changes in your health -- even things which don't seem related. For instance, if I am taking Chloramphenicol for more than 5 days, any pre-existing bruises fail to heal. Not only that, the they get steadily worse. As it wasn't obvious that the inability to heal bruising was related to the Chloramphenicol I didn't put 2 and 2 together initially. Chlormaphenicol can change your blood composition and while this is ususally pretty harmless, report anything amiss to the clinician looking after you so you can be monitored.

Hope everything sorts itself out !

Best wishes

Chris