Abstract
Aim: To identify the incidence of infectious keratitis in a population based in southern England.Methods: A retrospective review between January 1997 and December 2003 and a prospective study between January and December 2006 were undertaken at the eye casualty department of Queen Alexandra Hospital (QAH), Portsmouth, UK to identify the incidence of infectious keratitis.Results: QAH is a tertiary teaching hospital that serves Portsmouth and the catchment area of the county of Hampshire with an average population of 489,391 in the 7 year period of the retrospective study and 499100 in the one year prospective study. Infectious keratitis occurred in 1,786 patients in the retrospective study with an average of 255 patients per year and in 201 patients in the one year prospective study. The annual incidence of infectious keratitis was 52.1 and 40.3 per 100,000 persons in the retrospective and prospective studies respectively. The rate of bacterial and viral ulcers was lower in the prospective study than the average of either ulcer type in the retrospective study. A significant trend over time was found in the retrospective study that was mainly made by bacterial rather than viral ulcers. The rate of viral ulcers showed initial steady increase between 1997 and 2000 followed by continuous decline over the next three years of the retrospective study and maintained in the prospective study.Conclusions: Despite widely accepted views of the predominance of viral keratitis in the developed countries, these are decreasing in the population studied and contact lens-related bacterial corneal ulcers are more frequent than viral ulcers.
Highlights
Corneal ulceration is a vision-threatening disease that varies in incidence worldwide
Variations in incidence of infectious keratitis have been reported in different keratitis studies conducted in different countries even though these were similar in the degree of development, geographical location, and the most prevalent type of corneal infection and related predisposing factors [3,4,5,6,7]
It is thought that viral keratitis is more prevalent in developed countries, such as the United States where Herpes Simplex Keratitis (HSK) is considered the leading cause of corneal blindness [11,12]
Summary
Corneal ulceration is a vision-threatening disease that varies in incidence worldwide. Variation in incidence of infectious keratitis is a multi-factorial issue that includes a tight mix of different factors, such as geographical and other location-related factors [1], degree of development of the country concerned, the predominant predisposing factors and the type of infection commonly present in this community [2]. Variations in incidence of infectious keratitis have been reported in different keratitis studies conducted in different countries even though these were similar in the degree of development, geographical location, and the most prevalent type of corneal infection and related predisposing factors [3,4,5,6,7]. A declining incidence of Herpes Simplex Virus (HSV) eye disease including epithelial and stromal keratitis was recently reported in the USA [17]
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