Review Of Moraxella Corneal Ulcers Following 2 Simultaneously Presenting Cases From The Same Local Homeless Hostel

1. David Lockington
2. Amer Awan
3. Sanjay Mantry
4. Kanna Ramaesh

Tennent Institute of Ophthalmology, Glasgow, UK

Purpose: We aimed to review risk factors and evaluate all Moraxella positive corneal scrapes following 2 simultaneous cases from the same local homeless hostel.

Methods: A retrospective case review identified 12 patients between 2003 and 2008.

Results: 83% presented with hypopyon corneal ulcer. 75% had visual acuity < 6/60. 75% had known alcohol misuse, 75% had ocular surface disorders and 75% grew Moraxella alone. 100% were sensitive to Chloramphenicol. 54% required secondary surgical procedures for persistent epithelial defect.

Conclusions: Moraxella keratitis with alcohol misuse or ocular surface problems resulted in significant visual disability in our population. Although sensitive to Chloramphenicol, they can present in communities who don't access this commonly used 'over-the-counter' medication for social reasons. Earlier treatment could have limited the visual disability in both these immuno-compromised patients, raising the issue of access to services and treatment for this community. There is a need to actively identify and treat the ophthalmic needs of the homeless population.