EPIDEMIOLOGY AND AETIOLOGICAL DIAGNOSIS OF MICROBIAL KERATITIS: GUIDELINES FOR ITS TREATMENT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 63
Abstract
BACKGROUND Globally, it is estimated that ocular trauma and corneal ulceration result in 1.5–2 million cases of corneal blindness annually. 90% of such patients hail from developing countries, where the lesion has now been recognised as a silent epidemic. A National survey by the Government of India (1991–2001) estimated that corneal lesions were responsible for 9% of blindness in the country. The aim is to study various factors in epidemiology and aetiological diagnosis of suppurative keratitis in 50 patients attending the Department of Ophthalmology, Rajah Muthiah Medical College and Hospital during April 2015 to October 2016. MATERIALS AND METHODS This study was undertaken during the period from April 2015 to October 2016. 50 patients of corneal ulcer attending Ophthalmic Outpatient Department of Rajah Muthiah Medical College and Hospital were the subjects of this study. Visual acuity was recorded using Snellen visual acuity chart. Syringing was done to determine the patency of the nasolacrimal duct. The IOP was estimated by using digital pressure above the tarsal plate. Epithelial defect was demonstrated by fluorescein staining the size of the corneal ulcer and the level of the hypopyon is measured with slit lamp. Design- Prospective, observational study. RESULTS In this study of 50 cases of corneal ulcer, the following results were obtained. The percentage of fungal keratitis is 54% proved clinically and by culture and sensitivity while that of bacterial keratitis is 46%. The majority of patients were found in the Age group of less than 50 years, male patients showed higher prevalence than female patients. Most of the patients were agriculturists (64%). Right eye was affected more in patients (66%) due to right handedness of the individual. 64% of the patients presented with history of injury with stick (24%), paddy husk (12%) and thorn (12%). 24% of patients used topical medications like antibiotics and steroids prior to reporting. 86% of patients attended our OPD within 5 days of injury. The rest reported after 10 days. The size of the ulcer measured up to 4 mm in 94% of patients. The nasolacrimal duct was patent in 90% of patients. The most common bacteria identified was Staphylococcus 16% and Pneumococci 33%. As far as other eye is consent 54% were normal 20% showed lens changed and 10% were pseudophakics. The fungi identified were Aspergillus 27% and Fusarium 73%. CONCLUSION Treatment success is considered if there is complete healing of the ulcer within 2 weeks after starting therapy. Most of the patients came in advanced stages of the disease due to negligence, poor economic condition, ignorance, blind faith in native treatment.
Authors and Affiliations
Sridevi V
Keywords
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- EP ID EP231456
- DOI 10.14260/Jemds/2017/999
- Views 68
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