Medical judgment of microbial keratitis agent is possible based on clinical and epidemiological data, but it is more difficult for fungal infection. Thus, such data cannot be the only basis for the diagnosis of suspected microbial keratitis, but oriented clinical suspicion based on these data may be beneficial for guiding antimicrobial treatment and earlier therapy.

Fungal keratitis presented as a disease with severe complications, predominantly among young males, and was mostly caused by filamentous fungi. The present information permits the establishment of preventive strategies. Reducing the time between onset and treatment and using more accessible specific medication would reverse the negative prognosis.

PurposeFungi are a major cause of keratitis, although few medications are licensed for their treatment. The aim of this study is to observe the variation in commercialisation of antifungal eye drops, and to predict the seasonal distribution of fungal keratitis in Brazil.MethodsData from a retrospective study of antifungal eye drops sales from the only pharmaceutical ophthalmologic laboratory, authorized to dispense them in Brazil (Opthalmos) were gathered. These data were correlated with geographic and seasonal distribution of fungal keratitis in Brazil between July 2002 and June 2008.ResultsA total of 26,087 antifungal eye drop units were sold, with a mean of 2.3 per patient. There was significant variation in antifungal sales during the year (p<0.01). A linear regression model displayed a significant association between reduced relative humidity and antifungal drug sales (R2 = 0.17,p<0.01).ConclusionsAntifungal eye drops sales suggest that there is a seasonal distribution of fungal keratitis. A possible interpretation is that the third quarter of the year (a period when the climate is drier), when agricultural activity is more intense in Brazil, suggests a correlation with a higher incidence of fungal keratitis. A similar model could be applied to other diseases, that are managed with unique, or few, and monitorable medications to predict epidemiological aspects.

Despite the ubiquitous presence of water, the analysis of the risk factors associated with the active forms of the disease supports the idea that a low personal standard of hygiene and not water availability per se, is the key factor associated with trachoma.

The prevalence of VI among children aged 10 to 15 years in this typical Brazilian city is low and similar to other school-based studies, and most of the VI is caused by uncorrected myopia.

Objetivo: Descrever uma apresentação atípica de neurossífilis, caracterizada por neurite óptica bilateral em um paciente imunocompetente. Detalhamentos de Caso: Paciente sexo feminino, 58 anos de idade, com perda visual progressiva bilateral, de predomínio cecocentral, pupilas assimétricas, esquerda maior que a direitae reflexo fotomotor com menor reação à esquerda. Ao exame oftalmológico apresentava edema de disco óptico bilateral. A investigação revelou diagnóstico de neurite óptica bilateral secundária a neurossífilis. Iniciado tratamento com ceftriaxona devido falta de penicilina cristalina no serviço, dose de 2 gramas ao dia por 14 dias. A paciente evoluiu bem, com melhora progressiva dos sintomas visuais. Considerações finais: A sífilis é uma doença sistêmica com uma grande diversidade de sinais e sintomas. Essas características aumentam o risco de erros no diagnóstico e tratamento, com repercussões relevantes na morbidade e mortalidade. A neurite opticaisolada associada à neurossífilis é uma apresentação incomum da doença, e pode representar um desafiodiagnostico para a equipe médica.