Concerns About Antibiotic Resistance and Ocular Conditions

Q: Concerns About Antibiotic Resistance and Ocular Conditions

Hello： <br>Concerns about antibiotic resistance： Based on your description, the frequency of using Betamethasone eye ointment and Chloramphenicol eye drops is relatively low, which suggests a lower risk of developing antibiotic resistance. <br>Antibiotic resistance typically aris

Concerns about drug resistance and special diseases?

1.
I used the Betamethasone eye ointment only 4 times (before bed for 4 days) and the Chloramphenicol eye drops 5 times (5 drops over 5 days).
The main symptoms of photophobia, eye moisture, and the sensation of a foreign body in my right eye have not improved.
I consulted another physician to confirm that my upper eyelid inflammation had resolved and then stopped the medication.
I have only recently learned about antibiotics (it has been 5 days since I stopped).
Is there a high chance of developing antibiotic resistance? Should I urgently pursue a proper treatment regimen? Additionally, when Chloramphenicol was prescribed to me, it was at room temperature, but the bottle indicates it should be refrigerated.
I only realized later that I should have stored it in a cool place.
Is there a possibility that the clinic did not store it properly? It has been 8 days since it was opened; is it still usable?
2.
Symptoms: I initially felt a foreign body sensation (suspecting that large flakes may have blown in within the past few weeks).
I attempted to remove it myself using a cotton swab and my phone's flashlight (I noticed a transparent thread-like substance obscuring my vision) but was unsuccessful (I tried rinsing my eyes with a showerhead and using a warm towel).
After three days of struggling over the weekend, my right eye's vision became blurry, and I felt a decrease in visual acuity, as if my myopia had worsened.
My eyes, which were previously similar, now have significant photophobia.
Upon waking during the day, I quickly experience moisture in my eyes, and under fluorescent lights, I feel a foreign body sensation or prickling near my eyeball, often accompanied by eye moisture.
In contrast, my left eye feels clear, while my right eye has a sense of obstruction.
At night, car headlights appear particularly bright and glaring.
The afterimage in my right eye lingers longer, and even weak light tends to leave a residual glare, especially in dim or dark rooms.
When viewing the moon with my right eye, I see a halo to the left.
Wearing glasses provides some correction, but clarity does not last long.
When I blink, the halo from the left eye briefly appears.
The physician performed a slit lamp examination and confirmed that there is no corneal injury or cataract.
Should I now consider exploring the possibility of uveitis?

Xiwang Yanshen, 30~39 year old female. Ask Date: 2024/06/03

Dr. Gao Pilin reply Ophthalmology

Hello:
Concerns about antibiotic resistance: Based on your description, the frequency of using Betamethasone eye ointment and Chloramphenicol eye drops is relatively low, which suggests a lower risk of developing antibiotic resistance.
Antibiotic resistance typically arises from prolonged or inappropriate use, while short-term use generally does not lead to this issue.
However, to ensure proper treatment of your condition, it is advisable to follow your physician's instructions and complete the course of treatment, especially if symptoms have not improved.
Regarding the storage of Chloramphenicol eye drops, if the label indicates refrigeration is required, storing it at room temperature may affect its efficacy.
While keeping it in a cool place can mitigate some effects, it is still recommended to replace it with properly stored medication as soon as possible to ensure its effectiveness.
Analysis of symptoms: Based on your symptom description, issues such as photophobia, eye moisture, foreign body sensation, blurred vision, and persistent afterimages may have multiple causes.
You mentioned that your physician has ruled out corneal injury and cataracts through a slit lamp examination.
Here are several possible diagnostic directions:
1.
Dry Eye Syndrome: Dry eye syndrome can cause symptoms such as photophobia, eye moisture, and foreign body sensation.
You mentioned that your eyes are moist, but this does not exclude the possibility of dry eye syndrome, as it can also manifest as an excessive secretion response.
2.
Uveitis: Uveitis is an intraocular inflammation that may cause blurred vision, photophobia, and eye pain.
This is a direction worth exploring, especially after ruling out other common causes.
3.
Foreign body or injury on the ocular surface: Although you mentioned using a cotton swab and a showerhead to rinse your eyes, these methods may not completely remove foreign bodies and could potentially cause more irritation.
It is recommended to have a thorough examination by an ophthalmologist using professional tools.
4.
Other ocular diseases: Conditions such as glaucoma or retinal issues may also cause similar symptoms.
Further examination is warranted to determine if other eye diseases are present.
In summary, it is advisable to see an ophthalmologist as soon as possible.
Persistent blurred vision and photophobia may require more in-depth examination and professional treatment.

Reply Date: 2024/06/03

More Info

When it comes to antibiotic resistance and ocular conditions, your concerns are quite valid and reflect a growing awareness of the implications of antibiotic use. Let’s break down your questions and provide a comprehensive understanding.

Antibiotic Resistance and Usage
1. Antibiotic Resistance Risk: You mentioned using a topical antibiotic ointment (like Bacitracin) four times and chloramphenicol eye drops five times. The risk of developing antibiotic resistance is generally associated with prolonged or inappropriate use of antibiotics. In your case, the limited use of these antibiotics (only a few doses) suggests that the risk of developing resistance is low. Resistance typically arises from overuse or misuse, such as using antibiotics for viral infections or not completing a prescribed course. Since you have stopped using the antibiotics for five days and used them for a short duration, the likelihood of developing resistance is minimal.

2. Need for a Complete Course: If your symptoms have not improved, it is advisable to consult with your healthcare provider for a proper evaluation and possibly a more comprehensive treatment plan. Antibiotics should be used judiciously, and if your symptoms persist, it may indicate that a different treatment approach is necessary. Your healthcare provider may consider other medications or therapies based on your specific condition.

Storage and Efficacy of Chloramphenicol
1. Storage Conditions: Chloramphenicol eye drops should ideally be stored in a refrigerator to maintain their efficacy. If you have kept the drops at room temperature for eight days, it is essential to check the manufacturer's guidelines on the product label. Generally, if the medication has been stored improperly, it may lose potency, and using it could be ineffective or even harmful. It is best to consult your pharmacist or healthcare provider regarding whether the drops are still safe to use.

Ocular Symptoms and Potential Conditions
1. Symptoms Description: Your symptoms, including light sensitivity, a sensation of foreign body presence, and visual disturbances, warrant careful examination. The fact that you have experienced a change in vision and discomfort suggests that further investigation is necessary. While you mentioned that slit-lamp examinations ruled out corneal damage and cataracts, other conditions, such as uveitis (inflammation of the uveal tract), could indeed be a possibility.

2. Next Steps: Given the complexity of your symptoms, it is crucial to follow up with an ophthalmologist. They may perform additional tests to rule out conditions like uveitis or other inflammatory processes affecting the eye. Early diagnosis and treatment are vital to prevent potential complications, including vision loss.

Conclusion
In summary, your concerns about antibiotic resistance are well-founded, but the limited use of antibiotics in your case suggests a low risk. It is essential to consult with your healthcare provider for further evaluation of your ocular symptoms and to discuss the appropriate use of antibiotics. Proper storage of medications is crucial for their efficacy, and if there are any doubts about the safety of your eye drops, it is best to err on the side of caution and seek professional advice. Your eye health is paramount, and timely intervention can make a significant difference in your treatment outcomes.

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