Ocular pathogens cause many painful and vision‐threatening diseases such as infectious keratitis, uveitis, and endophthalmitis. While virulent pathogens and pathobionts play important roles in disease pathogenesis, the scientific community has long assumed disruption of the ocular surface occurs prior to microbial colonization and subsequent infection. While nonpathogenic bacteria are often detected in corneal and conjunctival cultures from healthy eyes, cultures also frequently fail to yield growth of common ocular pathogens or nonpathogenic bacteria. This prompts the following question: Is the ocular surface populated by a stable microbial population that cannot be detected using standard culture techniques? The study of the microbiome has recently become a widespread focus in physician and veterinary medicine. Research suggests a pivotal symbiotic relationship with these microbes to maintain healthy host tissues, and when altered is associated with various disease states (“dysbiosis”). The microbiota that lives within and on mammalian bodies have long been known to influence health and susceptibility to infection. However, limitations of traditional culture methods have resulted in an incomplete understanding of what many now call the “forgotten organ,” that is, the microbiome. With the introduction of high‐throughput sequencing, physician ophthalmology has recognized an ocular surface with much more diverse microbial communities than suspected based on traditional culture. This article reviews the salient features of the ocular surface microbiome and highlights important future applications following the advent of molecular techniques for microbial identification, including characterizing ocular surface microbiomes in our veterinary species and their potential role in management of infectious and inflammatory ocular diseases.

Next-generation sequencing (NGS) methods have been used to identify a diverse ocular surface (OS) microbiota in humans. These results have highlighted limitations in microbial detection via traditional culture-based techniques. The OS has mechanisms such as tear film and mechanical blinking, which may aid in preventing adherence and colonization of microbes, suggesting that only low populations of microbes may reside on the OS. Additionally, closely related tissues to the OS are exposed to a similar array of microbes, but demonstrate different defense mechanisms. Information regarding concordance of microbial communities of the OS and nearby tissues is lacking. Our study purposes were to (1) characterize the conjunctival microbiota of healthy dogs, (2) compare the conjunctival microbiota to the periocular haired skin and distal nose, and (3) compare the bacteria identified by culture to NGS of the healthy canine conjunctiva. Here, NGS was used to evaluate samples from 25 healthy adult dogs of the conjunctiva, periocular haired skin, and distal nose. Additional samples were collected from each dog for traditional conjunctival culture. The 16S rRNA gene amplicon libraries were evaluated for coverage, relative abundance, richness, and diversity. Site-dependent similarities evaluated using principal coordinate analysis (PCoA) and PERMANOVA demonstrated relatedness in community compositions between sites. The conjunctiva of healthy dogs yielded a rich and diverse microbiota based on NGS. While some regional continuity was noted, microbial communities of the conjunctiva, periocular haired skin, and nose were significantly different from each other. Comparatively, traditional culture markedly underestimated the number of bacterial taxa present on the healthy canine OS. Findings suggest similarities in nasal and conjunctival microbial communities, which may be a result of similarities in mucosal immunity and anatomic connection via the nasolacrimal system. Further investigation using NGS into changes of the composition of bacterial communities in disease is warranted.

Objectives To serially evaluate morphologic and elemental composition changes to diamond burr tips (DBTs) comparing two sterilization protocols. Animals studied A total of 300 fresh cadaver porcine globes. Procedures Six DBTs were randomly, equally assigned into Group 1 or 2, and then analyzed using Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS) at 0, 25, 50, and 100 cycles. Diamond burr debridement (DBD) was performed for 120 seconds on corneal stroma using the Algerbrush®. DBTs were cleaned, and then: Group 1 was sterilized by Germinator 500™; and Group 2 underwent ultrasonic cleaning and pre‐vacuum autoclave. A cycle is defined as one DBD, cleaning and sterilization protocol. Data were quantified using custom MatLab program. Results Energy Dispersive Spectroscopy revealed minor buildup of sulfur on both groups. Group 1 displayed major buildup of carbon and calcium. All DBTs were stippled with inorganic particulate at baseline. Particulates were no longer present on Group 2 by 25 cycles, but remained on Group 1 at all time points. There was significantly more buildup on Group 1 at all time points (P = 0.0000, 0.0009, and 0.0003 for 25, 50, and 100 cycles, respectively). More damage to Group 2 at all time points (P = 0.003, 0.002, and 0.003 for 25, 50, and 100 cycles, respectively) was observed. Conclusions No significant damage to Group 1 DBTs was noted after 100 cycles, however, particulate matter is not adequately removed using this sterilization technique. Ultrasonic cleaning is warranted between DBDs to achieve adequate particulate removal prior to sterilization; greater damage occurs with this technique which supports replacing DBTs regularly.