Steroids for Corneal Ulcers Trial

Inclusion Criteria At Presentation: * Presence of a corneal ulcer at presentation At Enrollment: * Presence of bacteria on blood or chocolate agar culture * Antibiotic given for \> 48 hours * The patient must be able to verbalize a basic understanding of the study after it is explained to the patient, as determined by physician examiner. This understanding must include a commitment to return for f/u visits. * Appropriate consent Exclusion Criteria At Presentation: * Overlying epithelial defect \< 0.75 mm at its greatest width at presentation * Corneal perforation or impending perforation * Evidence of fungus on KOH, Giemsa at time of presentation * Evidence of acanthamoeba by stain * Evidence of herpetic keratitis by history or exam * Corneal scar not easily distinguishable from current ulcer * Use of a topical steroid in the affected eye during the course of the present ulcer, including use after the symptoms of the ulcer started but before presentation * Use of systemic prednisolone during the course of the present ulcer * Age less than 16 years (before 16th birthday) * Bilateral ulcers * Previous penetrating keratoplasty * Pregnancy (by history or urine test) * Immediate steroid use necessary due to surgery or other condition At Enrollment: * Evidence of fungus on culture at time of enrollment * Absence of bacteria on blood or chocolate agar culture * Best spectacle-corrected vision worse than 6/60 in the fellow eye * Corneal perforation or descemetocele * Known a…