ABSTRACT
Introduction: Corneal ulcer is one of the important causesfor ocular morbidity in India. Early presentation with promptdiagnosis and treatment result in good visual rehabilitation.Aim: The aim of this study was to assess the etiology ofcorneal ulcer among patients attending the tertiary careteaching hospital of Jharkhand.Material and Methods: This was a prospective observationalhospital-based study conducted at the Department ofOphthalmology, at a tertiary care hospital, in Jharkhand.Data related to socioeconomic status, predisposing factor,and course of disease was collected. Results were analyzedon the basis of history, slit lamp examination, and appropriatelaboratory investigation.Result: During the study period of one year, 1013 patientswith the clinical diagnosis of corneal ulceration wereevaluated, mean age of the patient was 53 years and majorityof patients of infectious keratitis were in between 46 and 60(45%) age group. Incidence in male was higher than (59%)that of female. The left eye was more commonly involved(53%) as compared to the right eye (47%). Farmers (47%)followed by Industrial worker (27%) were most commonoccupation involved. Incidence of fungal keratitis (42%) washigher than bacterial (31%) and viral (11%).Conclusion: Proper diagnosis and management of cornealulcer is very much necessary among exposed population.Incidence of fungal corneal ulcer is very high amongagriculture and industrial workers and lack of awareness andpoor treatment leads to corneal blindness. Use of protectiveeye wear, masks and face shields may play a key role inprevention of the disease
ABSTRACT
Corneal perforation is a potentially devastating complication that can result from numerous conditions that precipitate corneal melting. It is associated with significant morbidity and prompt intervention is necessary to prevent further complications. Causes include microbial keratitis, ocular surface disease, and autoimmune disorders and trauma. Various management options have been described in the literature to facilitate visual rehabilitation. This rview discusses the treatment options that range from temporising measures such as corneal gluing through to corneal transplantation, with decision making guided by the location, size, and underlying aetiology of the perforation.
ABSTRACT
Introduction: Infective Keratitis is most common cause of corneal blindness in Rural India. Agricultural farmers are more at risk. Fungi and Bacteria are the main cause for this ocular ailment. Early diagnosis and treatment may prevent the corneal blindness. Aim: To evaluate common etiological factors causing Infective Keratitis in the region of Northern Telangana. Materials and Methods: This study was conducted at Tertiary Eye Care Hospital, Regional Eye Hospital, Warangal, Telangana State. Fifty patients were admitted with infective keratitis were clinically evaluated. Each case was analysed and results were recorded as per etiology, clinical symptoms and signs, complications and visual outcome. Results: Age group greater than 40 years (58%) were more common with male predominance (54%) was observed. People living rural area (72%) were affected more than urban areas. Agricultural labour (52%) was mostly seen with infective keratitis. Most of the cases were with trauma (62%) with vegetative matter was mostly seen. Most of the cases were acute (78%) in origin. Fungi were most common organism isolated from the cultures. Staphylococcus and Streptococcus (62%) were common species isolated from bacterial origin and they were antibiotic sensitive (92%). Aspergillous was common fungus isolated Diffuse Corneal ulcer was most common complication. Malnutrition was main cause in systemic illness. Most of the patients before treatment were with no passage of light after treatment visual acuity has prognosis to 6/18 vision. Conclusion: Early diagnosis and treatment may improve the visual prognosis and prevent Corneal blindness due to Infective Keratitis.
ABSTRACT
Purpose: To review the epidemiological characteristics, microbiological profile, and treatment outcome of patients with suspected microbial keratitis. Materials and Methods: Retrospective analysis of a non-comparative series from the database was done. All the patients presenting with corneal stromal infiltrate underwent standard microbiologic evaluation of their corneal scrapings, and smear and culture-guided antimicrobial therapy. Results: Out of 5897 suspected cases of microbial keratitis 3563 (60.4%) were culture-proven (bacterial – 1849, 51.9%; fungal – 1360, 38.2%; Acanthamoeba – 86, 2.4%; mixed – 268, 7.5%). Patients with agriculture-based activities were at 1.33 times (CI 1.16–1.51) greater risk of developing microbial keratitis and patients with ocular trauma were 5.33 times (CI 6.41–6.44) more likely to develop microbial keratitis. Potassium hydroxide with calcofluor white was most sensitive for detecting fungi (90.6%) and Acanthamoeba (84.0%) in corneal scrapings, however, Gram stain had a low sensitivity of 56.6% in detection of bacteria. Majority of the bacterial infections were caused by Staphylococcus epidermidis (42.3%) and Fusarium species (36.6%) was the leading cause of fungal infections. A significantly larger number of patients (691/1360, 50.8%) with fungal keratitis required surgical intervention compared to bacterial (799/1849, 43.2%) and Acanthamoeba (15/86, 17.4%) keratitis. Corneal healed scar was achieved in 75.5%, 64.8%, and 90.0% of patients with bacterial, fungal, and Acanthamoeba keratitis respectively. Conclusions: While diagnostic and treatment modalities are well in place the final outcome is suboptimal in fungal keratitis. With more effective treatment available for bacterial and Acanthamoeba keratitis, the treatment of fungal keratitis is truly a challenge.