Choosing the Right Medication for Keratitis: Expert Insights - Ophthalmology

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When it comes to choosing the right medication for keratitis, especially in the context of contact lens use, it is essential to consider the underlying cause of the symptoms and the specific diagnosis provided by the healthcare professionals. Based on your description, you have consulted two different doctors, each providing a different diagnosis and treatment plan. Let's break down the information provided and offer insights into the appropriate course of action.

1. Diagnosis and Treatment Options:
- The first doctor diagnosed you with corneal abrasion and the presence of "stones" (likely referring to deposits or calcifications) and prescribed Ophthalmic Erythromycin Ointment. Erythromycin is an antibiotic that can help prevent or treat bacterial infections, which is crucial if there is an abrasion that could become infected.

- The second doctor suggested that your symptoms were due to inflammation caused by contact lens wear and prescribed "善得明" (likely a combination of anti-inflammatory and antibiotic properties) and "溫拿可通" (Winacort Ointment), which is a corticosteroid ointment. Corticosteroids can help reduce inflammation but must be used cautiously, especially if there is a risk of infection.

2. Considerations for Contact Lens Users:
- Contact lens wearers are at a higher risk for keratitis due to the potential for irritation, abrasion, and infection. If you have been wearing contact lenses, it is crucial to ensure that they are clean and that you are following proper hygiene practices. Additionally, if there is any indication of infection or significant inflammation, it is advisable to discontinue contact lens use until the condition is resolved.

- The presence of white spots or particles in the eye could indicate a variety of issues, including foreign bodies, deposits, or even early signs of keratitis.
3. Choosing the Right Treatment:
- If the first doctor's diagnosis of corneal abrasion is accurate, using an antibiotic ointment like erythromycin is essential to prevent infection. Abrasions can lead to serious complications if not treated properly.

- If the second doctor's diagnosis of inflammation due to contact lens wear is correct, then anti-inflammatory medications may be necessary. However, using corticosteroids without addressing a potential infection can be risky.

4. Recommendations:
- Given the conflicting diagnoses, it may be beneficial to seek a third opinion from an ophthalmologist, particularly one who specializes in corneal diseases or contact lens-related issues. An ophthalmologist can perform a thorough examination, including a slit-lamp examination, to assess the condition of your cornea and determine the best course of treatment.

- If you experience increased redness, pain, or vision changes, seek immediate medical attention. These symptoms could indicate a more severe condition that requires prompt treatment.

5. General Advice:
- Avoid wearing contact lenses until the issue is resolved. This will help prevent further irritation and allow your eyes to heal.

- Maintain good hygiene practices when handling contact lenses, including washing your hands before touching your eyes or lenses and ensuring that your lenses are properly cleaned and stored.

- Follow up with your healthcare provider if your symptoms do not improve or worsen despite treatment.

In conclusion, the choice of medication for keratitis should be based on a clear understanding of the underlying cause of your symptoms. Given the complexity of your situation, consulting with a specialist is the best way to ensure that you receive the most appropriate and effective treatment.