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Established and emerging ancillary techniques in management of microbial keratitis: a review
  1. Dana Robaei1,2,3,
  2. Nicole Carnt1,
  3. Stephanie Watson1,4
  1. 1Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  2. 2Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia
  3. 3Westmead Millennium Institute for Medical Research, Westmead, New South Wales, Australia
  4. 4Corneal Unit, Sydney Eye Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Dana Robaei, Save Sight Institute, University of Sydney, 8 Macquarie St, Sydney, NSW 2000, Australia; dana.robaei{at}


Microbial keratitis is a sight-threatening condition and an ocular emergency, because of the potential for rapid progression. Intensive topical antimicrobials are the mainstay and the gold standard of treatment for microbial keratitis. However, despite appropriate diagnosis and therapy, treatment failure is still common, and can result in significant morbidity due to corneal perforation and/or scarring. For this reason, clinicians continue to seek novel treatment techniques in order to expand the armamentarium of tools available to manage microbial keratitis, and in doing so improve clinical outcomes. In this review, we examine the evidence for some established, as well as a few emerging ancillary techniques used to manage microbial keratitis. These include topical corticosteroids, corneal collagen cross-linking, intrastromal antimicrobials, amniotic membrane transplantation and miscellaneous other techniques. Of these, collagen cross-linking shows some promise for selected cases of infectious keratitis, although more research in the area is required before it is accepted as mainstream treatment for this potentially blinding condition.

  • Cornea
  • Ocular surface
  • Treatment other
  • Infection

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