Open Journal of Ophthalmology, 2017, 7, 64-72 http://www.scirp.org/journal/ojoph ISSN Online: 2165-7416 ISSN Print: 2165-7408 DOI: 10.4236/ojoph.2017.71010 February 23, 2017 Polymicrobial Keratitis—Importance of Detecting and Treating More Than One Organism Uma Sridhar 1 , Parul Jain 1 , Jyoti Batra 1 , Neelam Sapra 2 1 Cornea Services ICARE Eye Hospital, Noida, India 2 Sapra Microbiology Centre, Gurugram, India Abstract Corneal ulcers may become non-healing if inappropriately managed. Empiri- cally giving broad spectrum antibiotics or prescription of a “cocktail” of topical antibacterial, antifungal and antiviral medication may only add to drug toxicity and drug resistance. We present a series of four cases of microbial keratitis which are complicated due to presence of more than one causative organism. Microbiological work-up revealed Proteus species and fungal hyphae in smears only in the first case, atypical Mycobacteria and Staphyloccocus species in the second case, Moraxella and Streptococcus viridans in the third case and Asper- gillus flavus and Nocardia species in the fourth case. Authors would like to em- phasize the need for laboratory support in the treatment of corneal ulcers and importance of proper management of this sight threatening disease. Keywords Polymicrobial Keratitis, Broad Spectrum Antibiotics, Microbiological Work-Up 1. Introduction Microbial keratitis is one of the main causes of corneal blindness especially in the developing country. Management involves identification of the causative or- ganism and appropriate pharmacological therapy. However, either due to lack of laboratory support, or due to paucity of time in a busy clinic, availability of broad spectrum topical antibiotics or various other reasons, patient receives a “cocktail” of topical and systemic medications usually in inadequate dosages. This leads to the organism(s) developing resistance to the drug(s) and in addi- tion, there is damage to the ocular surface due to drug toxicity. The casual approach taken by many practitioners in the treatment of micro- How to cite this paper: Sridhar, U., Jain, P., Batra, J. and Sapra, N. (2017) Polymi- crobial Keratitis—Importance of Detecting and Treating More Than One Organism. Open Journal of Ophthalmology, 7, 64-72. https://doi.org/10.4236/ojoph.2017.71010 Received: January 22, 2017 Accepted: February 20, 2017 Published: February 23, 2017 Copyright © 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access