STUDY OF CLINICAL PROFILE AND RISK FACTORS OF INFECTED CORNEAL ULCERS AT RURAL TERTIARY CARE HOSPITAL

Abstract

Introduction: A corneal ulcer is a discontinuation in normal epithelial surface of cornea associated with necrosis of the surrounding corneal tissue. It is a major worldwide cause of preventable corneal blindness that is mostly under-reported but can be responsible every year for 1.5–2.0 million new cases of monocular blindness. Detailed studies of severe sight-threatening infectious keratitis are therefore important as they provide valuable information on the detection of etiology, predisposing factors, and visual outcomes to form the development of management strategies and protocols. Aims and Objectives: To study the clinical profile and known risk factors of infected corneal ulcers at rural tertiary care hospital. Materials and Methods: An Observational, Descriptive Cross-Sectional Hospital-based study was conducted after Institutional Ethical Committee (IEC) at the Department of Ophthalmology, DVPRMC, Loni. A total of 70 patients with infected corneal ulcers were screened and evaluated from June 2022 to May 2023 for a duration of 1 year. We studied the infected corneal ulcer patients above 18 years old attending to our hospital OPD. Results: 57% of patients were male and 43% were female. 66% of patients gave a history of trauma. The most common clinically diagnosed ulcer was fungal, representing 53% of all ulcers, followed by bacterial (27%) and viral (13%). There were also 2 cases each of acanthamoeba (3%) and pythium (3%) ulcers. 62.8% of cases were above 50 years old. In our study 73% of suspected fungal corneal ulcers were KOH smear-positive and 70% of suspected bacterial corneal ulcers were gram-positive. All cases were advised medical management. Out of those 43% were also advised therapeutic penetrating keratoplasty. Conclusion: Corneal ulcers are commonly seen in adult male farmers and laborers with ocular trauma in rural areas and fungal ulcer is the most common type of ulcer. Late presentation with corneal perforation requires therapeutic penetrating keratoplasty.