Medical No Nos

9/11/11Topical Steroids and Bacterial Keratitis DO NOT dose the steroid at a greater frequency thanthe topical antibiotic. DO NOT add the topical steroid until improvement isnoted in response to the antibiotic DO NOT add a topical steroid until topical antibioticshave been employed for a minimum of 48 – 72 hours.Topical Steroids and Corneal Thinning Topical steroids tend to further dehydrate the cornealstroma. Topical steroids can exacerbate stromal thinning. DO NOT use topical steroids without close monitoringif there is keratolysis (loss of stromal tissue) of greaterthan 75%.Sickle Cell Disease• Affects primarily people of African and Mediterraneandecent.• Results from mutations in the normal adulthemoglobin molecule (HgA), when valine issubstituted for glutamate at the 6 th position in thehemoglobin polypeptide chain.• Alters the dimensional structure of the molecule (HgS)and causes deformation of the RBC2