Profile of patients with ocular infections attending the out-patient department of a tertiary care centre in south India

Ipe A., Navaneetha N., Skariah R.


Background: Bacterial and viral etiologies are most commonly blamed for ocular infections. Studies have shown that gram positive cocci are responsible for maximum number of infections, followed by anaerobic bacteria and gram negative bacilli. Infections of the ocular adnexa, ocular surface and orbit usually present as conjunctivitis, keratitis, scleritis, orbital cellulitis and periorbital necrotising fascitis. The intra-ocular infections usually occur subsequently to a corneal ulcer, penetrating eye injury or a severe blood stream infection, and presents as iritis, uveitis, chorioretinitis or endophthalmitis. The aim of the study was to find out the clinico-demographic profile of patients who were diagnosed to have ocular infections at a large tertiary care teaching hospital in south India.

Methods: A retrospective study was designed to include all patients who came with suspected ocular infections to the out-patient department (OPD) of Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India, from July 2015 to December 2015.

Results: More than 50% of the participants reported ocular pain and around 60% has redness of the affected eye. Twenty five percent of the participants had discharge from the eyes and 56.7% reported persistent watering. Around 60% of the patients had irritation of the eye, while only 16.7% said that they feel blurring of vision. The final diagnosis was formed after careful examination by the senior most consultants available at the OPD and relevant investigations. Among the participants, 36.6% had conjunctivitis and 16.6% had corneal ulceration due to an infective cause. Around 13% has corneal abrasion, 11.6% had foreign body, 3% had dry eye and 3% had dacrocystitis.

Conclusions: Only around 55% of the patients with suspected eye infections turned out to be actual infections and a vast majority of that was due to conjunctivitis. Though majority of the patients presented with pain, redness, watering and discharge, these symptoms/signs cannot be used to differentiate infective etiology from a non-infective one.



Eye infections, Eye diseases, Etiology, India, Epidemiology, Anti-bacterial agents, Pharmacology

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McClellan KA. Mucosal defense of the outer eye. Surv Ophthalmol. 1997;42(3):233-46.

Donahue SP, Khoury JM, Kowalski RP. Common ocular infections. a prescriber's guide. Drugs. 1996;52(4):526-40.

Ooishi M, Miyao M. Antibiotic sensitivity of recent clinical isolates from patients with ocular infections. Ophthalmologica. 1997;211(1):15-24.

Ramesh S, Ramakrishnan R, Bharathi MJ, Amuthan M, Viswanathan S. Prevalence of bacterial pathogens causing ocular infections in South India. Indian J Pathol Microbiol. 2010;53(2):281-6.

Kaufman HE. Treatment of viral diseases of the cornea and external eye. Prog Retin Eye Res. 2000;19(1):69-85.

Klotz SA, Penn CC, Negvesky GJ, Butrus SI. Fungal and parasitic infections of the eye. Clin Microbiol Rev. 2000;13(4):662-85.

Sharma S. Ocular infections: research in India. Indian J Med Microbiol. 2010;28(2):91-4.

Sharma S. Antibiotic resistance in ocular bacterial pathogens. Indian J Med Microbiol. 2011;29(3):218-22.

Mcdonald M, Blondeau JM. Emerging antibiotic resistance in ocular infections and the role of fluoroquinolones. J Cataract Refract Surg. 2010;36(9):1588-98.

Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. J Am Med Asso. 2013;310(16):1721-9.

Buznach N, Dagan R, Greenberg D. Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era. Pediatr Infect Dis J. 2005;24(9):823-8.

Thielen TL, Castle SS, Terry JE. Anterior ocular infections: an overview of pathophysiology and treatment. Ann Pharmacother. 2000;34(2):235-46.

Visscher KL, Hutnik CML, Thomas M. Evidence-based treatment of acute infective conjunctivitis: breaking the cycle of antibiotic prescribing. Canadian Family Physician. 2009;55(11):1071-5.