"LONG-TERM TREATMENT WITH IDOXURIDINE AND STEROIDS"

Abstract

To the Editor: A note of caution should be added to the article by Drs. Dohlman and Zucker on Long-term Treatment with Idoxuridine and Steroids, ( Arch Ophthal 74:172-174, 1965). Concomitant administration of topical antibiotics with idoxuridine and steroids may prevent secondary bacterial infections, but an additional risk is undertaken—that of secondary mycotic keratitis. I recently saw a 25-year-old landscaper with a left herpetic keratitis (with slight stromal involvement) and iritis. Treatment consisted of idoxuridine ointment and suspension of prednisolone acetate 0.5% with polymyxin B sulfate and neomycin sulfate five times a day, and atropine. By the seventh day the stroma was clear and the dendrite was almost gone; treatment was continued. Three days later a white corneal ulcer appeared at the site of the former dendrite. Two days later, the infection appeared typically mycotic. Scraping and culture revealed Cephalosporium . Previous medication was replaced with hourly instillations of amphotericin B. When