A 72-year-old woman presented with vision loss in the left eye for 1 week. She reported use of over-the-counter (OTC) multiuse eye drops for bilateral dry eye syndrome. Physical examination was notable for visual acuity of light perception (LP) and a hypopyon filling the anterior chamber (Figure, A) with an epithelial defect (Figure, B) involving most of the cornea. Examination of the right eye was unremarkable. Culture of left corneal scrapings grew extensively drug-resistant Pseudomonas aeruginosa, susceptible only to cefiderocol. Culture of her OTC EzriCare artificial tears grew comparable drug-resistant P aeruginosa. She was treated with intravenous cefiderocol, topical imipenem/cilistatin, and topical polymyxin B/trimethroprim. Her course was complicated by a serous choroidal detachment detected by B-scan ultrasonography. At 2-month follow up, left-sided vision remained LP. On February 1, 2023, the US Centers for Disease Control and Prevention issued a health advisory1 regarding more than 50 similar infections associated with OTC artificial tears.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Published Online: March 22, 2023. doi:10.1001/jamaophthalmol.2023.1105
Corresponding Author: Ahmed F. Omar, MD, University Hospitals Eye Institute and the Department of Ophthalmology and Visual Sciences, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106 (email@example.com).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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