Evaluation of risk factors and treatment outcome of microbial keratitis in a tertiary eye center

Abstract

Purpose: To evaluate the risk factors and treatment outcome of microbial keratitis in a tertiary eye care centre. Methods: A hospital based prospective study in clinically diagnosed cases with microbial keratitis were enrolled. Corneal scrapes taken and subjected to direct microscopy and culture. Empirical treatment initiated following smear report and definitive treatment commenced after culture and sensitivity report. Patients were followed up for 3 months. Treatment outcome was assessed on the basis of signs of healing, scar formation, necessity of surgical intervention and severe complications. Results: A total of 95 patients were included. Microbial keratitis was common in the age group of 51-60 years with male preponderance. It was common in people involved in agricultural works, and frequent during the agricultural season of monsoon and spring. Among the predisposing factors, history of ocular trauma with vegetative matter is common. Majority presented before 14 days of onset of symptoms and also had history of prior treatment. Organisms were identified under direct microscopy in (38.9%) of cases and isolated in (51.6%) in culture medium. Streptococcus pneumoniae (22.1%) and Aspergillus (7.3%) were the most common bacterial and fungal isolate respectively. In vitro antibiotic sensitivity demonstrated bacteria were most sensitive to ofloxacin. A total of (75.8%) patients achieved complete healing whereas (10.5%) required surgical intervention. Conclusion: Early presentation, medication compliance and timely intervention can lead to good clinical and visual outcome in patients with microbial keratitis.