Corneal ulcer: an epidemiological, microbiological and clinical study of cases attending Assam medical college and hospital, Dibrugarh, India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20200784Keywords:
Corneal ulcer, Corneal scraping, Culture, Ocular traumaAbstract
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 were bacterial isolates and 12 were fungal isolates. All patients were treated according to standard treatment protocol and majority (95.5%) patients responded well to treatment.
Conclusions: This study has revealed that suppurative corneal ulcers are caused by both bacterial and fungal agents with bacterial preponderance in this geographical area. Early and accurate diagnosis and intensive treatment is the need of hour for saving the eye and preventing the catastrophe of lifelong blindness.
References
Bharathi MJ, Ramakrishnan R, Vasu S. Aetiological diagnosis of microbial keratitis in South India a study of 1618 cases. Indian J Med Microbiol. 2002;20(1):19.
Thylefor B. Epidemiological patterns ocular trauma. Aust Naj Ophthalmol. 1992;20:95-8.
Srinivasan M, Gonzales CA, George C, Cevallos V, Mascarenhas JM, Asokan B, et al. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India. British J Ophthalmol. 1997;81(11):965-71.
Panda A, Ahuja R, Sastry SS. Comparison of topical 0.3% ofloxacin with fortified tobramycin plus cefazolin in the treatment of bacterial keratitis. Eye. 1999;13(6):744.
Gupta R, Singh C, Mahajan B, Khurana AK. Microbiological regional profile of infective keratitis. Indian J Clinic Experimen Ophthalmol. 2015;1(4):264-72.
Gopinathan U, Sharma S, Garg P, Rao GN. Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade. Indian J Ophthalmol. 2009;57(4):273.
Dandona R, Dandona L. Review of findings of the Andhra Pradesh eye disease study: policy implications for eye-care services. Indian J Ophthalmology. 2001;49(4):215.
Hagan M, Wright E, Newman M, Dolin P, Johnson G. Causes of suppurative keratitis in Ghana. British J Ophthalmol. 1995;79(11):1024-8.
Nath R, Baruah S, Saikia L, Devi B, Borthakur A, Mahanta J. Mycotic corneal ulcers in upper Assam. Indian J Ophthalmol. 2012;60(4):336.
Suwal S, Bhandari D, Thapa P, Shrestha MK, Amatya J. Microbiological profile of corneal ulcer cases diagnosed in a tertiary care ophthalmological institute in Nepal. BMC Ophthalmol. 2016;16(1):209.
Sharma S, Srinivasan M, George C. The current status of Fusarium species in mycotic keratitis in South India. Indian J Medical Microbiol. 1993;11(2):140.
Dunlop AA, Wright ED, Howlader SA, Nazrul I, Husain R, McClellan K, et al. Suppurative corneal ulceration in Bangladesh: a study of 142 cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis. Australian New Zealand J Ophthalmology. 1994;22(2):105-10.
Upadhyay MP, Karmacharya PC, Koirala S, Tuladhar NR, Bryan LE, Smolin G, et al. Epidemiologic characteristics, predisposing factors, and etiologic diagnosis of corneal ulceration in Nepal. Am J Ophthalmol. 1991;111(1):92-9.
Basak SK, Basak S, Mohanta A, Bhowmick A. Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, eastern India. Indian J Ophthalmol. 2005;53(1):17.
