TY - JOUR
T1 - Demographic pattern, predisposing factors and management of ulcerative keratitis
T2 - Evaluation of one thousand unilateral cases at a tertiary care centre
AU - Panda, Anita
AU - Satpathy, Gita
AU - Nayak, Niranjan
AU - Kumar, Sandeep
AU - Kumar, Abhiyan
PY - 2007/1
Y1 - 2007/1
N2 - Purpose: To determine the predisposing factors, special clinical manifestations and the management of presumed microbial ulcerative keratitis. Methods: A retrospective study was performed in 1000 eyes of 1000 patients with presumed microbial keratitis. Information was recorded on patients' age and gender, risk factors, seasonal presentation, number of days since initiation of ulcer, prior therapy, clinical presentation, microbiological work-up and case management. Results: Fifty per cent ofthe patients with corneal ulcers were aged between 36 and 65 years and 13.3% were in the paediatric age group (1month to <16 years). The male:female ratio was almost 1.6:1. Only 11.4% of patients reported to the authors during the first week of initiation of ulcer. Trauma was the cause in 47.6% of eyes, and ocular surface diseases accounted for 16.6%. Forty-two per cent of eyes received topical antibiotics alone (either one or more) prior to hospital visit and 42.2% of eyes were on topical antibiotics and antifungals. Another 8.2% were on topical corticosteroids along with antibiotics and 4.6% were receiving some unidentified drop. Only 3% of the eyes did not receive any therapy prior to visit. Contact lens use as a risk factor could be identified only in 8.2% 51.7% of eyes. Medical therapy alone was effective in 61.0% of eyes and another 9.7% eyes responded to paramedian tarsorrhaphy along with topical antimicroboial drugs. Conclusion: Corneal ulcers are a frequent problem in this part of the world. The ulcers seen at this tertiary referral hospital present late in the natural history of the disease and are clinically severe. Despite the severity a majority of the eyes could be saved anatomically, but almost 65% of eyes were left with a visual acuity of <6/120. Considering the high magnitude of visual loss, public education about the potential for loss of sight and the importance of timely and appropriate treatment is recommended.
AB - Purpose: To determine the predisposing factors, special clinical manifestations and the management of presumed microbial ulcerative keratitis. Methods: A retrospective study was performed in 1000 eyes of 1000 patients with presumed microbial keratitis. Information was recorded on patients' age and gender, risk factors, seasonal presentation, number of days since initiation of ulcer, prior therapy, clinical presentation, microbiological work-up and case management. Results: Fifty per cent ofthe patients with corneal ulcers were aged between 36 and 65 years and 13.3% were in the paediatric age group (1month to <16 years). The male:female ratio was almost 1.6:1. Only 11.4% of patients reported to the authors during the first week of initiation of ulcer. Trauma was the cause in 47.6% of eyes, and ocular surface diseases accounted for 16.6%. Forty-two per cent of eyes received topical antibiotics alone (either one or more) prior to hospital visit and 42.2% of eyes were on topical antibiotics and antifungals. Another 8.2% were on topical corticosteroids along with antibiotics and 4.6% were receiving some unidentified drop. Only 3% of the eyes did not receive any therapy prior to visit. Contact lens use as a risk factor could be identified only in 8.2% 51.7% of eyes. Medical therapy alone was effective in 61.0% of eyes and another 9.7% eyes responded to paramedian tarsorrhaphy along with topical antimicroboial drugs. Conclusion: Corneal ulcers are a frequent problem in this part of the world. The ulcers seen at this tertiary referral hospital present late in the natural history of the disease and are clinically severe. Despite the severity a majority of the eyes could be saved anatomically, but almost 65% of eyes were left with a visual acuity of <6/120. Considering the high magnitude of visual loss, public education about the potential for loss of sight and the importance of timely and appropriate treatment is recommended.
KW - Keratitis
KW - Keratoplasty
KW - Natamycin
KW - Tarsorrhaphy
KW - Vasculoplasty
UR - http://www.scopus.com/inward/record.url?scp=33846670918&partnerID=8YFLogxK
U2 - 10.1111/j.1442-9071.2007.01417.x
DO - 10.1111/j.1442-9071.2007.01417.x
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C2 - 17300570
AN - SCOPUS:33846670918
SN - 1442-6404
VL - 35
SP - 44
EP - 50
JO - Clinical and Experimental Ophthalmology
JF - Clinical and Experimental Ophthalmology
IS - 1
ER -