PMC8664650_01
Slit-lamp examination revealed that the cornea of the right eye (A) was transparent, the upper corneal epithelium was poorly healed, and the anterior chamber was normal. (B) In the left eye, mixed congestion of the bulbar conjunctiva, corneal edema, and white infiltrating foci with crab-like changes with unclear boundaries of approximately 2x3mm2 in the center, unclear lesion boundaries with annular reaction ring, corneal endodermis and Descemet's folds radially perpendicular to the lesion, and sediments adhering to endodermis were observed.
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Slit-lamp examination revealed the cornea of the right eye transparent and the anterior chamber normal, but the upper corneal epithelium was poorly healed (Figure 1A). Moreover, corneal endodermis, Descemet's folds and sediments adhering to the endodermis white infiltrating foci with crab-like changes and unclear observed boundary was observed in the center of corneal, with an annular reaction ring, corneal endodermis, Descemet's folds and sediments adhering to the endodermis (Figure 1B).
Oct-optic (cassia) examination of the left eye revealed that the central cornea was swollen and cloudy up to a 1/2 depth.
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Oct-optic (cassia) of the left eye revealed that the central cornea was swollen and cloudy up to a depth of 1/2 (Figure 2).
Confocal microscopy of the left eye revealed that epithelial cells at the lesion site were necrotic and absent (A), with a large number of inflammatory cells infiltrating the superficial stromal layer (B). Turbidity and edema of the stromal layer, blurred endothelium, and highly reflective particles attached to corneal endodermis were also observed (C).
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Confocal microscopy of the left eye indicated epithelial cells necrotic and absent (Figure 3A), the stromal layer turbid and edema, endothelium blurred, with a large number of inflammatory cells infiltrating the superficial stromal layer (Figure 3B) and highly reflective particles attaching to the corneal endodermis (Figure 3C).
Microscopic examination with Giemsa staining on the conjunctival sac smear revealed more neutrophils and a small number of diplococci.
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Microscopic examination with Giemsa staining on the conjunctival sac smear showed many neutrophils and few diplococci (Figure 4).
Corneal scraping specimen culture by blood agar plate at 37 C for 36 hours. A large number of white, flat, slightly protruding, dry colonies were observed, with smooth, translucent surface and viridans hemolysis.
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At the same time, corneal scraping specimen culture results indicated large numbers of white and flat colony by blood AGAR plate at 37 C for 36 hours (Figure 5).
Gram-positive cocci, double-permutation or short chain-like permutation, negative thixoenzyme, and non-beta-hemolysis were observed via microscopy.
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Gram-positive cocci, double-permutation or short chain-like permutation, negative thixoenzyme, and non-beta-hemolysis were found via microscopy (Figure 6).
One month after the operation, the left eye infection was under control, and the nubecula remained in the center of the cornea.
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One month after the operation, infection of the left eye was under control, and the nubecula remained in the center of the cornea (Figure 7).