Title: A Clinical Scenario of Corneal Ulcer in A Rural Based Hospital
Author: Dr M.R.Madhavi, Dr K.Vijaykumar, Dr Prachee Nagrale, Dr Tejaswi Gude
DOI: http://dx.doi.org/10.18535/jmscr/v4i2.21
Purpose: Corneal ulcer is one of the major causes of blindness in developing countries Predisposing factors related to corneal ulcer are trauma, chronic ocular surface disease, contact lens usage, ocular surgery, corneal anaesthetic abuse, Diabetes mellitus, Vitamin deficiency, immunodeficiencies. Bacteria and fungi are frequently responsible for suppurative corneal ulcers. This study attempts in finding the etiology of corneal ulcers and its profile of clinical presentation and response to treatment in patients attending to a rural based hospital. Setting: Study was conducted and the data was collected at Mamata General Hospital, Khammam Design: The study design is a prospective cross-sectional study without any masking. Methods: The present study of aetiology and treatment of corneal ulcer was undertaken on the patients attending to Ophthalmic department of Mamata General Hospital, Khammam from September 2011 to September 2013. All the patients with corneal ulcers were identified and were selected for the study with the following inclusion and exclusion criteria Inclusion criteria: 1.Patients with corneal ulcers above 2 years of age. 2.All stages of corneal ulcer. Exclusion criteria: 1.Infants with corneal ulcers 2. Peripheral corneal ulcers with autoimmune etiology 3.Moorens ulcer Results: This study gives 1.The nature of trauma in relation to etiology of corneal ulcers, and its statistical significance. 2.The level of visual improvement with varied locations of ulcer over cornea and its statistical significance. 3.The level of visual improvement with varied etiology of corneal ulcer and its statistical significance. 4.To analyse possible method of reducing the incidence of corneal ulcers. Conclusions: In the study of 200 cases, it is observed that better results are obtained if the following measures are taken in the management of corneal ulcers: Health Education, Early Diagnosis, Immediate Treatment 1. Basak SK,BasakS,MohantaA,Bhomwick A. Epidemiological and microbiological diagnosis of suppurative keratitis in gangetic West Bengal,EasternIndia.Indian J Opthalmol 2005;53:17-22 2. Thylefor B. Epidemiological Patterns Ocular Trauma. Aust N A J Ophthalmol 1992; 20: 95-98. 3. Leek AK, Thomas PA, Hagan M, Kaliamurthy, Ackuaku E, John M, et al. Aetiology of Suppurative Corneal Ulcers in Ghana and South India, and Epidemiology of Fungal Keratitis. Br J Ophthalmol 2002; 86: 1211-1215. 4. P rosantGrag MS. Corneal Ulcer Diagnosis and Management. Community Eye Health 1997; 12:30. 5. Ross H W, Laibson PR. Keratomycosis. Am J Ophthalmol 1972; 74: 438441. 6. Ta nure MA, Cohen EJ, Sudesh S, et al. Spectrum of Fungal keratitis at Wills Eye Hospital Philadelphia, Pennsylvania. Cornea 2000; 19: 307-312. 7. Thomas PA. Mycotic keratitis – an underestimated mycosis. J Med Vet Mycol. 1994; 32: 235-256. 8. Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Epidemiological characteristics and laboratory diagnosis of fungal keratitis: A three-year study. Indian J Ophthalmol 2003;51:315-21. 9. Srinivasan M, Gonzales CA, George C, Cevallus V, MascarehasJM,AsokanB,et al. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India.Br J Ophthalmol 1997;81:965-71. 10. Bashir G, Shah A, Thokar MA, Rashid S, Shakeel S. Bacterial and fungal profile of corneal ulcers.A prospective study. Indian J PatholMicrobiol 2005;48:273-7. 11. Hagan M, Wright E, Newman M, Dolin P, Johnson GJ.Causes of suppurative keratitis in Ghana. Br J Ophthalmol 1995;79:1024-8. 12. Leck AK, Thomas PA, Hagan M, Kaliamurthy, Ackuau E, John M, et al. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Ophthalmol 2002;86:1211-5. 13. Verenker MP, Borkar S, Pinto MJ, Pradeep N. Study of mycotic keratitis in Goa.Indian J Med Microbiol 1998;16:58-60. 14. Rahman AK. A Study on External Ocular Infections (Bacterial and Fungal) with Emphasis on Corneal Ulcer ( Unpublished M. Phil. Thesis), Department of Microbiology, IPGMR, Dhaka, Bangladesh, 1995. 15. Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Shivkumar C, Palaniappan R. Epidemiology of bacterial keratitis in a referral centre in south India. Indian J Med Microbiol 2003;21:239-45. 16. Steinert RF. Current Therapy for Bacterial Keratitis and Bacterial Conjunctivitis. Am J Ophthalmol 1991;112 (Suppl): 10- 14. 17. Kunimoto DY, Sharma S, Gary P, Gopinathan U, Miller D, Rao G. Corneal ulceration in the elderly in Hyderabad, South India. Br J Ophthalmol.2000; 84:54-59. 18. Mirshahi A, Ojaghi H, Aghashahi D, Jabarvand M. Fungal keratitis in patients at Farabi Hospital, Tehran (1998- 1999) [in Persian]. Bina. 1999; 5(2): 135-143. 19. Berenji F, Elahi SR, Fata AM, Khakshour H, Darakhshan A. Fungal keratitis in patients at Imam Reza Hospital, Mashhad (1982-2001) [ in Persian]. Med J Mashhad Univ Med Sci. 2003; 45:49-54.Abstract
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