**Eye Coinfections**

[71] Kitzmann AS, Goins KM, Sutphin JE, Wagoner MD: Keratoplasty for treatment of *Acanthamoeba* keratitis. Ophthalmology. 2009;116(5):864-869. doi:10.1016/j.ophtha.

[72] Garduño-Vieyra L, González-Sánchez CR, Hernández-Da Mota SE: Ultraviolet-A light and riboflavin therapy for *Acanthamoeba* keratitis: a case report. Case Reports in

[73] Khan YA, Kashiwabuchi RT, Martins SA, Castro-Combs JM, Kalyani S, Stanley P, Flikier D, Behrens A: Riboflavin and ultraviolet light a therapy as an adjuvant treat‐ ment for medically refractive *Acanthamoeba* keratitis: report of 3 cases. Ophthalmolo‐

[74] Tabibian D, Richoz O, Hafezi F: PACK-CXL: Corneal cross-linking for treatment of infectious keratitis. Journal Ophthalmic and Vision Research. 2015;10(1):77-80.

[75] Claerhout I, Goegebuer A, Van Den Broecke C., Kestelyn P:Delay in diagnosis and outcome of *Acanthamoeba* keratitis. Graefes Archive for Clinical and Experimental

2008.12.029.

120 Advances in Common Eye Infections

Ophthalmology. 2011;2(2):291–295.

Ophthalmology. 2004;242(8):648-653.

gy. 2011;118(2),324–331.

Carlos Alberto Pantoja-Meléndez, Victor M. Bautista-de Lucio, Mariana Ortiz-Casas, Jonathan Quevedo-Martínez and Herlinda Mejía-López

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/64702

#### **Abstract**

Ocular infections are an *ophthalmologic* emergency that threatens the eye's integrity, which may result in a poor visual outcome; hence, it requires prompt treatment. The most common microorganisms involved in eye infection are the bacteria, followed by vi‐ rus and fungi; however the prevalence depends on the geographic location. It is essential to know The etiologic agent of the ocular infection ocular infections and their antibiotic sensitivity because the geographical situation and the urbanization level of the studied population will determine their prevalence. Recently have been described eye coinfec‐ tions, where at least two microorganisms can infect at the same time and the same ana‐ tomic site. Several coinfections have been published, bacteria-bacteria, bacteria-fungus, bacteria-virus, fungus-yeast, fungus-virus, parasite-bacteria, etc. Eye coinfections repre‐ sent a particular challenge for the ophthalmologists; coinfections are difficult to diagnose because often the clinical characteristic is atypical and mimics different clinical pictures. In addition, eye coinfections respond poorly to antibiotics and usually present an aggres‐ sive clinical course. In these circumstances, it is common for patients to receive multiple treatments when they should be receiving a specific treatment. Several risk factors are im‐ portant to develop coinfections, e.g., trauma, dry eye, use of contact lenses, and comor‐ bidities (diabetes and immunosuppression). Coinfections have been described in keratitis, conjunctivitis, and endophthalmitis. The study of polymicrobial biofilms has been increasing, and in the medical area, the role played by biofilms in confections has been associated with virulence factors; hence, biofilm formation is also considered a de‐ terminant virulence factor for pathogenesis in the host. Coinfection diagnosis is an impor‐ tant topic in order to obtain a specific and timely diagnosis. Microbiological and molecular approaches are proposed to identify etiological agents. Delay in diagnosis af‐ fects the sensitivity to specific treatments and the evolution of infection. Treatment and prognosis are supported by a specific diagnosis.

**Keywords:** Coinfection, polyinfections, biofilm

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
