Purpose To analyse the spectrum of bacterial keratitis isolates and their in vitro antibiotic susceptibilities over a 10-year period in Oxford, UK; and to compare the in vitro efficacy of ciprofloxacin with that of the combination of gentamicin and cefuroxime over the same period. Methods All culture-positive corneal scrapes received from the Oxford Eye Hospital between July 1999 and June 2009 were identified retrospectively using a local microbiology database. For analysis of trends over time, the data was split into two equal 5-year periods. Statistical analysis was done using the v 2 and Fisher exact tests. Results Over the 10-year study period, 467 corneal scrapes were performed of which 252 (54.0%) had positive bacterial cultures, growing a total of 267 organisms. The most commonly isolated bacteria were Staphylococci (40.1%) followed by Pseudomonas species (28.5%), other Gramnegative species (17.2%), Streptococci (7.1%), and Corynebacteria (6.0%). Between the first and second time periods there was an increase in the number of coagulase-negative Staphylococci and an increased resistance of the non-Pseudomonas Gram-negative group to chloramphenicol. Of the 189 isolates tested for sensitivity to both empirical antibiotic regimens, 176 (93.2%) were susceptible to ciprofloxacin whereas 188 (99.5%) were susceptible to either gentamicin or cefuroxime (P ¼ 0.0015). Conclusions The spectrum of bacterial keratitis isolates and their in vitro antibiotic sensitivity patterns have generally remained stable over time. The combination of gentamicin and cefuroxime provides a broader spectrum of antimicrobial cover than ciprofloxacin monotherapy in Oxford, although both regimens continue to be appropriate choices for the initial management of this condition.

Aims-To determine the anatomical site and underlying causes of blindness and severe visual impairment in children under 16 years of age in special education in the People's Republic of China with a view to determining potentially preventable and treatable causes. Methods-A national study of children attending schools for the blind in China was conducted between April and June 1998 using the WHO Prevention of Blindness Programme (WHO/PBL) eye examination record for children with blindness and low vision. Eight Chinese ophthalmologists attended a training workshop before conducting the study. 36 blind schools in 18 provinces of China were included. Results-1245 children aged between 5 and 15 years were examined, of whom 1131 (91%) were blind or severely visually impaired (visual acuity less than 6/60 in the better eye). The commonest anatomical sites of visual loss were whole globe (mainly microphthalmos) 25.5% and retina (mainly dystrophies) 24.9%. Lens was the major site in 18.8%, optic nerve in 13.6%, and glaucoma in 9%. Corneal scarring was not a major cause of visual loss. The aetiology was unknown in 52.9%, hereditary factors were responsible in 30.7%, and childhood causes in 14%. 15% of cases were considered potentially preventable and 22.5% potentially treatable. Conclusion-The pattern of childhood blindness seen in this study is likely to reflect the improved health and socioeconomic status of China but may partly reflect bias in admission to, and location of, blind schools, with higher socioeconomic groups overrepresented. Nutritional and infective causes of blindness are uncommon, and hereditary and unknown factors are now the predominant causes. (Br J Ophthalmol 1999;83:929-932) For a child who is born blind or who becomes blind the total number of years of disability are greater than for a person who becomes blind later in life. Currently it is estimated that there are 1.5 million blind children in the world, of whom one million live in Asia. In order to set priorities for control programmes, baseline epidemiological data of the prevalence and major causes of childhood blindness are required. These are known to vary between regions and countries.1 No data are available for China.The WHO Prevention of Blindness Programme with the International Centre for Eye Health has developed a standard methodology and reporting form to record the causes of visual loss in children with the emphasis on the identification of preventable or treatable causes of blindness. This methodology has now been used in many countries. 2China has a population of 1200 million (1996) of which 378 million are under 18 years of age. China's 22 provinces, five autonomous regions, and 5000 islands are governed from Beijing. (Hong Kong has a special status.) The population is mainly Han Chinese (over 90%) but there are also 200 diVerent ethnic minority groups. The country has a literacy rate of 82%. Health indicators have shown a marked improvement in recent years-for example, the infant mortality (under 1 year) has improved f...

Major congenital abnormalities of the globe are important causes of severe visual loss in children, particularly in Asian countries. Further research into etiology is warranted in order to plan prevention programs.

Over the time period of this study there was no evidence of emerging resistance to empirical antibiotics which are commonly used for the treatment of bacterial endophthalmitis. Infection with coagulase-negative Staphylococci was associated with a good visual outcome, whilst infection with Streptococcus spp. or Haemophilus influenzae was associated with a poor visual outcome.

Developmental eye defects such as coloboma are a significant cause of visual morbidity in children, and are more common in India than elsewhere. The possible role of environmental factors in the aetiology of these conditions was investigated by studying birth order, symptoms of vitamin A deficiency (night blindness), drug use and maternal illness in pregnancy, rubella antibodies and exposure to agricultural chemicals. Through hospital records and community-based rehabilitation programmes in Andhra Pradesh, children with colobomata were recruited from schools for the blind. Eighty-three mothers of affected children were interviewed. The results showed that 43% of parents were consanguineous, that 19% had a positive family history and that the frequency of coloboma was highest in second-born children. Eleven (16%) mothers had a history of night blindness while pregnant with the affected child; seven (8%) took medication during the 1st trimester, abortifacients in two cases; three reported fever in the 1st trimester; and 11 (13%) reported exposure to agricultural chemicals.