AFB, Acid fast bacilli – Eye/Ear

Corneal Scrapes:
○ For corneal scrapes, corneal surfaces should be rinsed thoroughly with sterile normal saline to remove anaesthetic prior to collecting specimen; use a Kimura scalpel to scrape across the ulcer using short firm strokes in one direction; obtain 3 to 5 scrapings per cornea. Avoid contact with eyelids/eyelashes. Inoculate scrapings into MGIT tube, agar slants, and onto microscope slide and place slide into slide holder.
Conjunctival/eye swab:
○ Conjunctival surfaces should be rinsed thoroughly with normal saline to remove anaesthetic prior to collecting specimen. Roll a sterile pre-moistened swab over the conjunctiva and place in transport medium
○ Collect samples from both affected and unaffected eyes to compare microbial growth using different swabs/transport media for each eye
Intraocular fluids:
○ Collect an aspirate of vitreous fluid or paracentesis of anterior chamber using a needle aspiration technique. Dispense fluid into sterile container.
Lacrimal stone/secretions:
○ For lacrimal stones, collect stones using sterile technique and place into sterile container.
○ For lacrimal secretions, collect visible purulent discharge using a swab or press lacrimal sac to remove exudate for culture. Do not perform a needle aspiration of the lacrimal gland.
External ear swab:
○ Insert clean, sterile swab into ear canal until resistance is met. Rotate swab to collect fluid on swab and place in transport medium.
○ If ear drum is ruptured, collect exudate on swab after inserting through an auditory speculum
Tympanocentesis fluid
○ Clean external ear canal with mild detergent. Use a syringe to aspirate fluid from the eardrum. Dispense fluid into a sterile container and transport to laboratory.
○ If anaerobic culture required, dispense some of the aspirated fluid into an anaerobic transport medium
Devices:
○ Collect device and place in sterile container using aseptic technique where possible to avoid contamination