In contrast to other studies from the northern United States, we found Fusarium sp the most commonly isolated filamentous fungus. In our series, C. albicans was the most frequent cause of fungal keratitis, and a past history of ocular trauma was uncommon.

Simple excision of ocular surface squamous neoplasms appears to result in a higher recurrence rate when compared to excision with adjunctive cryotherapy. Judicious cryotherapy to the involved limbus and conjunctival margins results in recurrence rates comparable with other, more extensive cryotherapy procedures. This technique of cryotherapy has very few adverse effects on the eye.

Herpes simplex virus (HSV) is a leading cause of chronic infectious ocular disease in the United States. The morbidity from recurrent herpetic episodes is high, and the resultant corneal scarring may require penetrating keratoplasty for visual rehabilitation. Effective treatments for acute episodes of HSV have been verified by early Herpetic Eye Disease Study (HEDS) trials. The recent HEDS trial on the efficacy of oral acyclovir as prophylaxis against recurrent stromal keratitis represents the first report of a treatment likely to reduce long-term scarring from herpetic disease. This article reviews all the HEDS trials and the implications of their findings for the management of patients with ocular HSV.

The intra- and inter-observer variability of Goldmann applanation tonometry was studied in 8 hospital tonometrists, 4 of whom received brief revision training in tonometer use. Intraocular pressure (IOP) measurements were obtained from 16 glaucoma patients. Over a series of four readings taken from individual eyes, intraocular pressure did not significantly vary. However, a decline in IOP was observed when a second tonometrist obtained a further series of four readings from a previously measured eye. Mean pressures recorded by tonometrists who had received revision training were greater than those obtained by the untrained observers though this could be accounted for by two highly experienced individuals in the untrained group who tended to record low pressures. Comparisons of average readings obtained by two observers on the same eye showed that approximately one-quarter of measurements differed by 2 or more mmHg and approximately one-fifth by 3 or more mmHg.

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Fungal keratitis following DSAEK occurs in a sequestered space and therefore represents a treatment challenge with potentially devastating outcome. We recommend an aggressive surgical approach with early removal of the donor button and irrigation with intracameral antifungal agents.

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