Indian Journal of Clinical and Experimental Ophthalmology


A cross sectional study on clinico microbiological profile of patients with fungal corneal ulcer attending a tertiary care hospital of Shimoga district, Karnataka


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Author Details: Poonam A. Jiragyal

Volume : 2

Issue : 4

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 299

Article End Page : 303


Abstract

Introduction: Corneal ulceration is the most common cause of preventable blindness, second only to cataract in developing countries. Mycotic keratitis accounts of 30-62% of all culture positive infectious keratitis in several Indian studies. Mycotic keratitis is a significant problem in a country like India with a predominantly agrarian population, who encounter ocular trauma with vegetative material.
Aim: To study the clinical profile of patients with fungal corneal ulcers in relation to age, sex, risk factors, clinical presentation and laboratory diagnosis in the outpatient department of a tertiary care hospital of Shimoga district.
Materials and Methods: A prospective cross sectional study was carried out on all consecutive patients presenting with corneal ulcer attending the out-patient department of a tertiary care hospital of Shimoga district, Karnataka, between August 2013 to July – 2014.
Results: Out of the total 90 cases of corneal ulcer, 30 were fungal culture positive. Out of these 30 cases, males [21, 70%] were affected more than females [P < 0.0001]. The age group most commonly affected was 31-40 years [8, 26.67%], patients [24, 80%] residing in rural areas were more affected and most patients were agricultural workers [19, 63.6%]. Corneal trauma [27, 90%] was the most common risk factor [P < 0.0001] and 17 patients [62.96%] had history of trauma with vegetative matter [P < 0.0001]. Incidence of fungal corneal ulcer was highest during the paddy harvesting season. The sensitivity of 10% KOH wet mount preparation was higher [96.96%] than gram – stained smear [87.88%S] [P < 0.0001].
Fungal culture was positive in 30 cases [33.33%]. The most commonly isolated fungal species was Fusarium species [12 cases, 40%] followed by Aspergillus species [8 cases, 26.66%].
Conclusion: Ocular trauma with vegetative material especially in agriculture workers was an important cause of mycotic keratitis. Direct microscopic examination of KOH wet mount preparation is a rapid, sensitive, technique of laboratory diagnosis in mycotic keratitis. It is particularly important for the early initiation of antifungal treatment.

Keywords
: Clinico-microbiological profile, Culture, Fungal keratitis, microscopy, Risk factors

Doi No:-10.18231