Current Trend of Corneal Ulcer In Patients Attending a Tertiary Healthcare Centre (original) (raw)
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International Journal of Research in Medical Sciences, 2020
Background: Corneal ulcer is one of the important ophthalmic conditions causing significant morbidity especially in the developing countries. This study was carried out to evaluate the common etiological agents, predisposing factors, age, gender and occupational distribution and to study the clinical features and management of all corneal ulcers.Methods: A total of 50 cases of corneal ulcers who attended the Ophthalmology outpatient department (OPD) of Assam medical college and hospital, Assam, India, over a 6 months period were included in the study. A detailed history was taken and examination done as per the proforma. Microscopy and culture were performed on all corneal specimens obtained.Results: Corneal ulcers were common in 3rd to 5th decades of life with Male to Female ratio of 1.3:1. Majority of patients were farmers or hired agricultural workers. Ocular trauma was the major predisposing factor in majority of cases (32%). Out of 50 cases, 31 (62%) were culture positive. 19 w...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Corneal ulcer is one of the leading causes of ocular morbidity in developing country. Early diagnosis and targeted therapy is indispensable. Sociodemographic variables along with predisposing factors plays a major role in its development and clinicopathological correlation in diagnosis is very much helpful in diagnosis and subsequent management. The aim of the study is to identify the epidemiological factors and causative organism of the suppurative corneal ulcer. MATERIALS AND METHODS In this observational cross-sectional study, after taking proper history, patients with suppurative corneal ulcer are examined for clinical diagnosis. Applying sterile method of swab collection from the ulcer for standard microbiological examination (staining, culture) swabs are taken for predetermined laboratory investigations. Sociodemographic variables (age, gender, occupation) relevant injury history, microbiological data are tabulated for statistical calculations. RESULTS After application of inclusion and exclusion criteria wiling 81 patients, M:F=55:26 were assessed. Major number of patients (n=61, 75.30%) are middle aged between 33-62 years of age. Occupation played a major role as evidenced by 44.44% (n=36) contribution from agricultural workers (tea garden worker, pineapple farmer, other agricultural worker) followed by household worker (n=13, 16.05%). Positive history of prior corneal injury is common in fungal corneal ulcer (n=22, 51.16%) as well as in bacterial (n=8, 66.66%). Among the prior corneal injury associated fungal ulcer vegetative matter injury in 15 patients (32.60%), while in bacterial variety, it is 5 (10.86%) in number. In laboratory investigations, pure fungal growths are found in 37 patients (45.68%), while pure bacterial are 12 in number (14.81%). A good number (n=8, 9.81%) shows mixed infection. Culture negative ulcers are good in number (n=24, 29.63%) among which 6 (7.47%) are microscopically positive. The sensitivity and specificity of clinical diagnosis of fungal corneal ulcer are 84.61% and 72.41% respectively with a high correlation between clinical and microbiological diagnosis of fungal corneal ulcer (either smear positive or culture positive and a quiet high positive predictive value for clinical diagnosis (84.61%). But, in case of bacterial corneal ulcer, the positive predictive value is 41.37%, while negative predictive value is 84.61% in our study. CONCLUSION Middle-aged agricultural workers are more prone to develop corneal ulcer and fungal corneal ulcers are more prevalent in this region of India than bacterial. History of prior corneal injury is a major risk factor. Fungal corneal ulcers have high correlation between clinical and microbiological diagnosis than bacterial.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.7\_July2021/IJRR-Abstract032.html, 2021
Background-Visual impairment due to corneal ulceration has for long been acknowledged as leading cause of blindness both worldwide and in India only next to Cataract. The aetiology for infective corneal ulcer varies considerably with occupation of patients in different regions of India. Thus, continuing with empirical management without lab diagnosis leads to protracted clinical course. So, understanding the microbial profile of corneal ulcers in agriculture dependent population of Southern Assam helps in improved management of this morbidity. Aims- To 1) Find the prevalence of infected corneal ulcers in untreated patients attending Ophthalmology department of a tertiary care hospital of Southern Assam. 2) Study the pattern of microbial aetiology in the infected corneal ulcer cases. 3) Find the association of infected corneal ulcers with various attributing factors. Method-Corneal scrapings from 86 routine untreated cases of corneal ulceration from Ophthalmology Department were studied prospectively from Dec2017 to Jan2019 and subjected to Gram staining and direct examination with 10%KOH. Culture on SDA and Blood Agar were incubated at 25°C and 37°C respectively and followed up for 3 weeks before declaring sterile. Antimicrobial sensitivity was performed for bacterial isolate and yeast-like species. Slide culture and LPCB tease mount were done for identification of moulds. Result- Out of the 86 cases, 58 were positive in direct microscopy, of which 44 were culture positive. Of the 28 samples negative in direct microscopy, 2 were positive by Culture. Bacterial isolates were found in 5 cases and fungal aetiology in 41 cases. Conclusion- The prevalence of infected corneal ulcer as per standard of Culture positivity is 53.5% (46/86). Mycotic involvement was found in 90% cases. Important fungal isolates identified were Aspergillus species, Penicillium species, Curvularia species, Fusarium species, Sarocladium species. Higher prevalence was significantly associated with harvesting season, agricultural practice and history of trauma while diabetes and steroid intake were not significantly associated with mycotic ulcers.
Journal of Evolution of Medical and Dental Sciences, 2020
BACKGROUND Corneal ulcer is a global burden which is an ocular emergency. The outcome of corneal ulcer depends on its management. Aetiology, microbiological flora and antibiotic sensitivity vary from region to region. We wanted to analyse the epidemiology of corneal ulcer in Barak valley region of Assam. METHODS This is a cross-sectional study conducted from May 2017 to June 2018 at Silchar Medical College, Silchar, Assam, India. Cases of corneal ulcer in the study period were included. Corneal scrapping was done, and the sample was sent for Gram stain, KOH mount stain and culture-sensitivity testing. RESULTS A total of 122 patients were examined and 70 cases had positive microbiological findings. Pure bacterial isolates were found in 37 (52.8%) of the 70 cultures and pure fungal isolates in 23 (32.8%) of the cultures. Staphylococcus aureus was the most commonly isolated bacterial organism (42.5%). Out of fungal isolate, Aspergillus spp. (46.7%), was the commonest. Farmers were the most commonly affected work group. CONCLUSIONS Although the major aetiological agents in our study were bacterial, fungal ulcers were also seen in a significant proportion of patients. Staphylococcus was the major bacterial isolate and Aspergillus was the major fungal isolate.
Etiology of Suppurative Corneal Ulcers in Rural Population of Northern India
Indian Journal of Clinical and Experimental Ophthalmology, 2015
Background: A prospective, interventional, comparative study carried out in rural population of northern India in western UP. Fungal keratitis studies available in literature were also reviewed. Methods: Patients presenting in eye OPD of UPRIMS & R Saifai, Etawah, UP with suspected microbial keratitis were recruited to the study. Corneal ulceration was defined as loss of corneal epithelium with clinical evidence of infection in form of corneal infiltrate with or without hypopyon. Microscopy and culture were performed on all corneal specimens. Results: A total of 105 patients presenting with suppurative keratitis were enrolled in the study from Jan 2014 to April 2015. Fungi were identified as the dominant causative agent of infection (including mixed infections) in 52 patients (49.52%). Bacteria were isolated from 32 cases (30.47%). Mixed infection was present in 9 cases (8.57%). In each case of mixed infection a single bacterial species was associated with a single fungal species. I...
2020
Introduction: Corneal ulcer is one of the important causes for ocular morbidity in India. Early presentation with prompt diagnosis and treatment result in good visual rehabilitation. Aim: The aim of this study was to assess the etiology of corneal ulcer among patients attending the tertiary care teaching hospital of Jharkhand. Material and Methods: This was a prospective observational hospital-based study conducted at the Department of Ophthalmology, at a tertiary care hospital, in Jharkhand. Data related to socioeconomic status, predisposing factor, and course of disease was collected. Results were analyzed on the basis of history, slit lamp examination, and appropriate laboratory investigation. Result: During the study period of one year, 1013 patients with the clinical diagnosis of corneal ulceration were evaluated, mean age of the patient was 53 years and majority of patients of infectious keratitis were in between 46 and 60 (45%) age group. Incidence in male was higher than (59...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Corneal ulcer is an open sore on cornea causing significant morbidity especially in developing countries. It is associated with redness, watering, photophobia, pain and decreased vision of that eye. It is a vision threatening emergency and may lead to corneal scarring and perforation. If left untreated it may progress to endophthalmitis. So, an early diagnosis with recognition of the causative agent is very much essential to preserve vision. We conducted this study to evaluate the risk factors, causative organisms, and patient demographics of microbial keratitis. METHODS All new patients with suspected suppurative keratitis presenting at the ophthalmology OPD of Calcutta National Medical College and Hospital for a period of 1 year were evaluated. Sociodemographic data, visual acuity at presentation, and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping was performed. Microscopy and culture were performed on all corneal specimens obtained. From this data we tried to find out the epidemiological pattern and factors involved in suppurative corneal ulcer. RESULTS One hundred and fifty cases of suppurative keratitis were studied clinically and microbiologically. Study showed a male preponderance (73.33%) with cultivators constituting the major occupational group (29.33%). Trauma was the commonest pre-disposing factor (64%). Among the 114 (76%) culture positive cases, 62 (41.33%) patients had pure fungal infection, 33 (22%) patients had pure bacterial infections and 19 cases (12.67%) had mixed fungal and bacterial infections. Aspergillus spp. were the most common fungal isolate, while among the bacteria positive cases, the main isolates were Staphylococcus aureus, Pseudomonas sp. and Pneumococcus. CONCLUSIONS Suppurative corneal ulcer is an important cause of preventable blindness. Smear and culture is an essential tool in the diagnosis of these infections. Region based information about the causative organisms and risk factors helps in empirical management, and to formulate guidelines for prevention of suppurative keratitis in the population at risk.
Etiological agents of corneal ulcer: five years prospective study in eastern Nepal
Nepal Medical College journal : NMCJ, 2012
To identify the most common isolates from the corneal ulcers with antimicrobial pattern of bacterial isolates. All patients with suspected corneal ulceration presenting to BP Koirala Institute of Health Sciences from Jan 2004 - Dec 2008 were evaluated. Corneal scraping was performed and processed for direct microscopy, bacteriological and fungal culture. Bacterial isolates were subjected to antimicrobial susceptibility testing. Of 351 specimens examined, growth of etiological agents were obtained in 278 (79.20%). Of these, 113 (40.65%) had pure fungal growth, 108 (38.85%) had pure bacterial growth and 57 (20.50%) had mixed fungal and bacterial infection. The commonest fungal pathogen was Aspergillus spp 50 (33.33%) followed by Fusarium spp 19 (12.66%). Staphylococcal aureus 57 (44.53%) was isolated as commonest bacterial agent. Coagulase Negative Staphylococci 20 (15.6%) was second in the list. Pseudomonas spp 12 (9.40%) was the most common gram negative bacilli isolated. Most of th...
TO STUDY THE CAUSATIVE ORGANISM RESPONSIBLE FOR CORNEAL ULCER IN S.S.G HOSPITAL VADODARA, GUJARAT
National Journal of Community Medicine, 2011
Introduction: Number of blind people in the world is 45 million. Out of which 5.4 million blind people are in our country. Corneal ulcer is a major cause of blindness throughout the world. About 10% cases of blindness are due to corneal ulcer. Aims: To detect bacteria or fungus causing corneal ulcers and to give rapid presumptive diagnosis from direct smear examination. Study Design: 150 samples were collected during period of 1 year from clinically diagnosed cases of corneal ulcer at SSG Hospital, Baroda. The patients were of both sex and age groups varying from 2 to 70 years, outpatient department as well as indoor patients Study Period: one and half years Results: A total number of 150 patients presenting with suppurative keratitis were enrolled in the study from Ophthalmology department, SSG Hospital & Medical College, Baroda. Of the total 150 patients 99 (66%) were males & 51 (44%) were females with ulceration occurs in both group most frequently in the middle decades of life.