{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:19:45Z","timestamp":1791389985752,"version":"4.3.3"},"reference-count":55,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Eye Institute","award":["K08 EY033859"],"award-info":[{"award-number":["K08 EY033859"]}]},{"name":"National Eye Institute","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}]},{"name":"Career Development Award from the Research to Prevent Blindness","award":["K08 EY033859"],"award-info":[{"award-number":["K08 EY033859"]}]},{"name":"Career Development Award from the Research to Prevent Blindness","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}]},{"name":"All May See Foundation","award":["K08 EY033859"],"award-info":[{"award-number":["K08 EY033859"]}]},{"name":"All May See Foundation","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}]},{"name":"UCSF Vision Core Grant","award":["K08 EY033859"],"award-info":[{"award-number":["K08 EY033859"]}]},{"name":"UCSF Vision Core Grant","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}]},{"name":"Research to Prevent Blindness","award":["K08 EY033859"],"award-info":[{"award-number":["K08 EY033859"]}]},{"name":"Research to Prevent Blindness","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Infectious keratitis (IK), including bacterial, fungal, parasitic, and viral etiologies, continues to represent a significant cause of ocular morbidity in the United States and around the world. Corneal scraping for smears and cultures remains the gold standard in diagnosing IK; however, molecular diagnoses, including metagenomic deep sequencing (MDS), are promising emerging diagnostic tools. Despite recent interest in procedural treatment such as riboflavin photoactivated chromophore corneal collagen cross-linking (PACK-CXL) and Rose Bengal photodynamic antimicrobial therapy (RB-PDAT), medical treatment advances have remained stagnant. Methods: This review highlights IK pathogens obtained from corneal cultures at Bascom Palmer Eye Institute (BPEI) from 2011 to 2021 and provides the current BPEI algorithms for initial management of IK or as a referred clinically worsening patient. The roles of corticosteroid therapy, PACK-CXL, and RB-PDAT for IK are also summarized. Results: A total of 9326 corneal cultures were performed at BPEI between 2011 and 2021, and only 3609 (38.7%) had a positive organism identified, of which bacteria were the most common (83.4%). Fortified vancomycin and tobramycin are recommended as first-line medical therapy for IK patients based on culture sensitivity data for the top Gram-negative (Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus) bacteria. PACK-CXL and RB-PDAT may benefit IK patients with corneal melting and fungal IK, respectively. Conclusions: Drug holidays, minimizing contamination, and optimizing sample order are crucial to maximizing corneal culture positivity. PACK-CXL and RB-PDAT are promising procedural advancements for IK therapy.<\/jats:p>","DOI":"10.3390\/jcm14175987","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T06:08:37Z","timestamp":1756102117000},"page":"5987","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Infectious Keratitis Management: 10-Year Update"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-5221","authenticated-orcid":false,"given":"Neel D.","family":"Pasricha","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, CA 94158, USA"},{"name":"Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-1528","authenticated-orcid":false,"given":"Pablo","family":"Larco","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene","family":"Miller","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego S.","family":"Altamirano","sequence":"additional","affiliation":[{"name":"Instituto Oftalmol\u00f3gico Integral, Santiago 8320214, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Rose-Nussbaumer","sequence":"additional","affiliation":[{"name":"Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA 94158, USA"},{"name":"Department of Ophthalmology, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo C.","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2854-0626","authenticated-orcid":false,"given":"Guillermo","family":"Amescua","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob. 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