Clinical profile and visual morbidity of patients with infectious keratitis in rural area of Pawapuri, Bihar, India: A hospital based prospective study (original) (raw)
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Nepalese Journal of Ophthalmology, 2010
Background: Corneal ulcer is one of the major causes of monocular blindness in developing countries. Objective: To determine demographic pattern, risk factors, microbiological pattern and treatment outcome of infective keratitis. Materials and methods: A retrospective analysis of hospital records of 44 patients with clinically-diagnosed infective keratitis presenting to B.P. Koirala Institute of Health Sciences in the eastern region of Nepal was carried out. Outcome measures: The parameters studied were risk factors and organisms responsible for keratitis. Results: The infective keratitis was mostly prevalent among the males between 21-40 years of age (50%). 79.5 % of them were engaged in agricultural work. A history of corneal injury was found in 30 eyes (68.1%). Vegetative matter was the most common agent of trauma in 17 (56.6%). Culture positivity for microorganisms was observed in 20 (45.5%) samples. Of these, 8 (40%) patients had purely bacterial corneal ulcer. Purely fungal gr...
Epidemiology and Factors Affecting Visual Acuity in Fungal Keratitis in Eastern Uttar Pradesh
Indian Journal of Clinical and Experimental Ophthalmology, 2015
Background: Fungi can cause devastating ocular infections like keratitis and endophthalmitis; however, there are limited studies available on the epidemiology and risk factors of fungal ocular infections in Northern India. The aim of this study is to determine the epidemiology and factors affecting visual acuity in fungal keratitis, in population of Eastern Uttar Pradesh. Methods: All patients were reviewed for demographic features, predisposing factors, prior therapy, clinical features, microbiological findings, medical and surgical treatment, and outcome of therapy. For microbiological study corneal scrapings were taken by the Ophthalmologist using sterile blades. For the isolation of fungi, samples were inoculated on specific media and KOH mount were done .The identification of fungi was performed by microscopic evaluation and growth on specific media. Different epidemiological factors and risk factors were assed and compared to find association of risk factors to visual acuity i...
IP International Journal of Ocular Oncology and Oculoplasty, 2020
Introduction: Given the rise in cases of fungal keratitis in recent years, this study was performed to better elucidate the clinical and microbiological profile, risk factors and intervention rates of fungal keratitis at a tertiary referral center in Uttarakhand. Methods: Corneal scraping was collected from 53 consecutive cases of suspected fungal keratitis and was subjected to direct staining and culture. Results: This was a prospective observational study conducted over a period of 1 year after approval from the institutional ethical committee. All the patients which appeared to be fungal or mixed keratitis on clinical examination were included in this study. Out of 53 patients, 37 (69.8%) were males and 16 (30.2%) females with a mean age of 46.04 ± 16.23 years. Maximum patients 18 (33.96%) had the onset of symptoms and signs in the months of July-September. Of all the corneal ulcer which appeared fungal on clinical examination, KOH and culture was positive in 50.9% patients. While 18.9% were mixed type having both KOH and Gram stain positive. Out of 53 patients, 23 had presence of 3 or more typical clinical features of fungal keratits. There was significant association between number of clinical features and KOH and culture positivity. Fusarium and Curvularia species were the most common etiological agents in our region. Conclusions: Predominant outdoor agricultural activity and trauma with vegetative matter was the principal causative factor for corneal injury. Corneal ulcers complicated due to prior treatment by village healers and hence another important concern. The information regarding regional etiology will help empirical management as many eye clinics do not have microbiological facilities.
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...
National Journal of Medical Research, 2014
Introduction: Mycotic keratitis is an important ophthalmologic problem especially in developing countries. Fungal infection is a fatal condition which needs early diagnosis and treatment to save the patient’s eye Objective: The purpose of this study was to study etiology, epidemiological characteristics and common predisposing factors responsible for ocular infection. Materials and Methods: Corneal scrapings from 100 patients of corneal ulcer with suspected fungal aetiology were subjected to direct examination by 10 per cent KOH mount, Gram stain and culture. The laboratory results along with clinical and epidemiological data were examined and analyzed. Result: Of the 100 patients of investigated, in 24 cases fungal aetiology was identified. It was seen that ocular trauma was the most common predisposing factor which was correlating with the occupation. Aspergillus spp was the most common fungus isolated in 11 cases, followed by Fusarium spp. (5) and Curvularia spp. (3). Yeasts were also isolated 3 cases. Conclusion: In conclusion, the major element in the diagnosis of mycotic keratitis is the clinical suspicion by the ophthalmologists and laboratory confirmation of the fungus.
Infectious Keratitis in Western Nepal: An Experience from a Tertiary Care Hospital
2018
Background: Corneal blindness is a major public health problem worldwide and infectious keratitis is one of its leading causes. The aim was is to analyze the microbial etiology of corneal ulcers and to determine the antibiotic susceptibility pattern of bacterial isolates in order to find out the existing drug resistance pattern. Methods: Corneal scrapings were collected as per the standard procedure. All the isolates were identifies by conventional microbiological techniques. Antibiotic susceptibility testing was performed using disc diffusion method. Clinical grading of the ulcerative lesion was carried out by the recommended protocol. Results: Among the 84 cases of clinically diagnosed infectious keratitis investigated, 33 (39.3%) were farmers by occupation. All cases were reviewed for predisposing conditions and clinical severity. Ulcers were categorized as mild in 49 cases moderate in 12 and severe in 23 cases. Predisposing conditions were found in 55(65.5%) of the 84 cases. For...
Background: Corneal blindness is a major public health problem worldwide and infectious keratitis is one of the predominant causes. About half of corneal ulcers are fungal in tropical zones where the population is predominantly rural. People living in a tropical climate and working in agriculture are clearly significant risks, possibly amplified by the lack of safety precautions in the less advanced agricultural societies. Aims: To identify predisposing factors, causative fungi and to study different presentations of mycotic keratitis in the indigenous population of Manipur. Materials and methods: A cross sectional study was conducted in 25 patients with suppurative corneal ulcer attending to Ophthalmology Department in collaboration with Department of Microbiology, RIMS Hospital, Imphal, over a period of 2 years. (October 2013 to September 2015). Results: Highest incidence of mycotic corneal ulcer was found between 21-50 years of age. Males were only marginally more affected by corneal ulcer than females. Farmers were the most common occupational group affected by corneal ulcer (52%), followed by housewives (16%). The maximum number of corneal ulcer patients attended during the months of November–December (52%), followed by March-April (20%) and January-February (12%). Paddy leaf injury was the most common agent causing injury to the eye resulting in corneal ulcer, constituting 36% of all the ocular trauma. 50 % of the isolated fungi from SDA culture were found to be Fusarium Spp. and the rest 50% comprises of Aspergillus Spp. and Scedosporium Spp. Conclusion: In the present study, it was found that corneal ulcer was common in 31-60 years of age, with marginally higher incidence in male sex. Farmers were most commonly involved regarding occupation and the most common cause of corneal ulcer was attributable to injury by paddy leaf during harvesting season, which falls in the months of November and December. Fusarium constituted 50%, Aspergillus and Scedosporium 25% each as fungal species causing keratitis.
Journal of Kathmandu Medical College
Background: Corneal ulcer is a sight threatening disease of significant public health concern. Early diagnosis with microbiological identification of the causative organism and institution of the proper medical therapy are important for successful visual recovery. Objectives: To find out the demographic and predisposing factors associated with corneal ulcers, evaluate management of ulcers on the basis of clinical features and corneal scraping results. Methods: It was a retrospective clinical study conducted among 1897 subjects with microbial keratitis in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from January 2010 to December 2014. Assessment included detailed eye examination with slit lamp for size, depth and location of ulcer, presenting visual acuity on internally illuminated Snellen's chart, and corneal scrapings for Gram's stain and 10% Potassium hydroxide wet mount. A standard treatment was delivered on the basis of clinical features and corneal scraping results. Subjects were evaluated subsequently after 48 hours, one week, two weeks, three weeks and four weeks of initiation of therapy. Non-responding cases were admitted to perform re-scraping and to modify therapy. Results: Majority of subjects (71.2%) belonged to the age group of 26 to 55 years (71.2%), presented after two weeks (82.3%) and used non-prescription eye drops (71.9%) before visiting to the eye hospital. Ocular trauma (54.5%) was the most commonly reported predisposing factor. The central and paracentral ulcers comprised of 72.8% of ulcers withsize greater than 2mm in 2.7% and moderate ulcer in 71.1%. Microbiological test revealed fungal ulcers in 78.1% subjects. Presenting visual acuity better than 6/18 was reported in 7% only. Conclusion: Corneal ulcer was one of the commonly reported eye disease in Terai region of Nepal. Trauma is the commonest cause of corneal infection. Fungal corneal ulcers werecommonly noted.
PREVALENCE OF FUNGAL KERATITIS IN RURAL POPULATION -AN INDIAN BASED PROSPECTIVE; RETROSPECTIVE STUDY
IASET, 2013
Introduction: Fungal keratitis is a major eye disease leading to blindness in South Asia. Many authors has reported in South India, it was found that 44% of all central corneal ulcers are caused by fungi. This high prevalence of fungal pathogens in South India is significantly greater than that found in similar studies in Nepal (17%), Bangladesh (36%), Ghana (37.6%), and south Florida (35%). In Indian perspectives the incidence of fungal keratitis is being increased during the past decade, due to Intemperate and retrogressive climatic changes. The present study aims to find out the incidence of fungal keratitis in rural population.