Abstract

Volume.119 Number.12

Original article : Case report

Severe Ocular Infection in Elderly Patients with Dementia: a Case Study
Yuka Miyamura1,2, Chie Sotozono1, Hisayo Higashihara1,3, Saichi Hoshi4, Shigeru Kinoshita1
1 Department of Ophthalmology, Kyoto Prefectural University of Medicine
2 Department of Ophthalmology, Ayabe City Hospital
3 Higashihara Clinic
4 Department of Ophthalmology, National Center for Geriatrics and Gerontology

Purpose: To report 3 cases of severe ocular infection in elderly patients with dementia.
Case reports: Case 1 involved a 75-year-old man who presented after his wife noticed hyperemia and discharge in his right eye. Corneal infection with perforation was found. Wife-administered antibiotics healed the infection within 1 month. Case 2 involved a 97-year-old man who was referred to us after nursing-home staff members noticed redness and discharge in his right eye. Severe corneal infection with hypopyon was found. Following systemic and topical and antibiotics' administration by the nursing-home staff, the infectious keratitis healed within 2 weeks. Case 3 involved an 80-year-old woman referred to us from another clinic due to persistent epithelial defect in her left eye. Since the defect was accompanied by anterior uveitis and vitreous opacity, we suspected bacterial endophthalmitis. Following systemic and topical antibiotics' administration by family members, signs of infection diminished within 3 weeks. In all 3 cases, medical examination was difficult, topical eye-drop instillation by the patients themselves was impossible.
Conclusions: In elderly dementia patients, cognizance of infection, medical examination, and treatment are difficult. Support by family members or nursing-home staff is necessary to obtain improved outcomes.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 119: 863-867, 2015.

Key words
Aging, Dementia, Severe ocular infection
Reprint requests to
Chie Sotozono, M.D. Department of Opthalmology, Kyoto Prefectural University of Medicine. 465 Kajii-cho, Hirokouji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-0841, Japan