Epidemiological, Clinical, Therapeutic and Evolutionary Aspects of Corneal Abscesses at the Teaching Hospital of Bouaké (Côte d’Ivoire)

Abstract

Introduction: The purpose of this study was to describe the epidemiological, clinical, therapeutic and evolutionary aspects of corneal abscesses treated in the ophthalmology department at the Teaching Hospital of Bouaké, in order to contribute to an improvement in their management. Materials and methods: A longitudinal retrospective study based on the analysis of medical records of patients with corneal abscesses who received follow-up in the department. from 1 January 2012 to 31 December 2016 and 21 cases of unilateral abscesses were collected from a total of 18,585 cases. Results: The frequency of corneal abscesses was 0.11%. The average age of patients was 27.71 years (1-year and 73-year extremes) with a male predominance (1.1 sex ratio). Housewives and farmers accounted for 57.14%. Patients were admitted more than 7 days after the onset of signs in 33.33% of cases. At admission, the visual acuity of the affected eye was less than 1/20 in 16 patients (76.19%) and among them, 6 had no light perception. The abscess was localized to the left eye in 11 patients (52.38%). Its largest diameter was greater than 2 millimetres in 14 patients (66.66%), its seat was in the visual axis in 10 patients (47.61%) and in 12 patients (57.14%), its depth exceeded two-thirds of the corneal thickness. Corneal perforation was observed in 6 cases (28.57%) and severity factors were found in 19 patients (90.47%). No microbiological examination was performed and treatment was based on probabilistic antibiotic therapy. The cure was achieved but at the cost of anatomical sequelae whose functional consequences were visual acuity less than 1/20 in 76.19% of cases. Conclusion: corneal abscesses are infrequent but very serious with poor prognosis in our conditions. This prognosis can be improved by early and adequate management, including microbiology-guided antibiotic therapy.