MICROBIOLOGICAL PROFILE IN PATIENTS WITH CONGENITAL NASO LACRIMAL DUCT OBSTRUCTION

Abstract

AIM: To study and evaluate the different organisms that are responsible for congenital nasolacrimal duct obstruction .To initiate appropriate antimicrobials based on the sensitivity patterns of the isolated organisms. Methods: It is a prospective study conducted in Sarojini Devi Eye hospital during September 2016 to February 2018. 112 samples from 100 cases were collected from clinically diagnosed congenital nasolacrimal duct obstruction with epiphora below 1 year without any ocular and systemic diseases .Swabs taken were analysed for causative microorganisms of congenital nasolacrimal duct obstruction. Results: In our study out of 112 samples[88 unilateral cases+12 bilateral cases ]82 cases [73.21%] were culture positive, of which80 [71.42%]were bacterial,2 cases [1.78%]were mixed [ bacterial +fungal].Gram positive bacteria were predominant, staphylococcus epidermidis 56[68.29%] followed by Staphylococcus aureus 13[15.85%].Among gram negative bacteria Escherichia coli 1 [1.21%], klebsiella 1[1.21%]. 2 cases were mixed [bacteria +fungal]. Infection is more commonly seen in right eye. Rate of infection was higher in females 62[55.35].Higher incidence of infection was seen in the age group of less than 7 months. Both gram positive and gram negative were most susceptible to tobramycin. Conclusion: Among all the congenital nasolacrimal duct obstructions 90% of the cases would resolve spontaneously with medical therapy and Criggler massage. 10 % of the cases require probing and silicon tube intubation. The knowledge of identification , awareness and bacteriology of congenital nasolacrimal duct obstruction by the paediatricians , physicians and the parents would contribute to the choice of effective antimicrobials and reduce keratitis medicamentosa ,induced astigmatism due to excessive eye rubbing and apprehension among the parents.