Title: Clinical and Microbiological Profile of Bacterial and Fungal Corneal Ulcers
Authors: Dr Manjusha N.S. Dr Manoj Venugopal
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.148
Abstract
The study was done to determine the predisposing factors, specific pathogenic organisms and visual outcome in patients presenting with corneal ulcers in Department of Ophthalmology, TDMCH, Alappuzha. Patients above the age of 12 years with bacterial or fungal corneal ulcer as confirmed by staining, from 1 January 2012 to 30 June 2013 were included in the study. The patients were examined and corneal scrapings were taken. A history of previous corneal injury with vegetative matter was present in 34% of subjects. Staining reports showed 76% of cases were fungal infection and 24% cases were bacterial infection. Culture positivity was obtained in 88% cases and 12 % were culture negative. Of those with positive culture 66% had fungal infection and 22% had bacterial infection. Among the bacteria isolated 20% were Staphylococcus aureus and among the fungi isolated 56% were Fusarium species. The best corrected visual acuity was recorded using Snellen’s chart at the end of 3 months. 28% had vision in the range of 6/24 - 6/60. This study concludes that corneal ulceration most often occurs after a corneal injury with organic material, with fungal infections showing a marked preponderance over bacterial infection. Fusarium species in fungal infections and Staphylococcus aureus in bacterial infections were mostly isolated. The final visual outcome is good with early diagnosis and prompt treatment. These findings show the importance of early identification as well as treatment of corneal ulceration in the prevention of corneal ulceration in a developing world.
Keywords: corneal ulcer, bacteria; fungi; visual outcome.
