Purpose: To investigate the demography, causative bacteria, and clinical findings in 3 patients with expulsive hemorrhage.
Methods: The clinical records of 3 patients (3 eyes), who developed expulsive hemorrhage because of infectious keratitis and were treated at our hospital between December 2006 and January 2008, were investigated retrospectively.
Results: Three women, older than 70 years, with physical and mental disabilities because of senile dementia were studied. Two were residents at a nursing home. Basic corneal disorders included bullous keratopathy, cicatricial syphilitic keratitis, and traumatic keratitis because of a foreign body. All patients developed expulsive hemorrhage. Two patients underwent enucleation, and 1 underwent bulbar exenteration with sclerocorneal patch for expulsive hemorrhage. Bacterial culture in these cases isolated either Capnocytophaga sp. and penicillin-intermediate resistant Streptococcus pneumoniae or methicillin-resistant Staphylococcus aureus.
Conclusions: This is the first recorded case of Capnocytophaga keratitis in Japan. Patients with dementia may develop severe ocular complications after infectious keratitis because of their inability to communicate.