EPIDEMIOLOGY AND FACTORS AFFECTING VISUAL ACUITY IN FUNGAL KERATITIS IN EASTERN UTTAR PRADESH

Review Article

Author Details : Sujit Deshmukh, Shraddha Pandey, Rajendra P. Maurya, Mahendra K Singh, Virendra P Singh, Ishan Yadav

Volume : 1, Issue : 2, Year : 2015

Article Page : 68-75

Abstract

Background: Fungi can cause devastating ocular infections like keratitis and endophthalmitis; however, there are limited studies available on the epidemiology and risk factors of fungal ocular infections in Northern India. The aim of this study is to determine the epidemiology and factors affecting visual acuity in fungal keratitis, in population of Eastern Uttar Pradesh.

Methods: All patients were reviewed for demographic features, predisposing factors, prior therapy, clinical features, microbiological findings, medical and surgical treatment, and outcome of therapy. For microbiological study corneal scrapings were taken by the Ophthalmologist using sterile blades. For the isolation of fungi, samples were inoculated on specific media and KOH mount were done .The identification of fungi was performed by microscopic evaluation and growth on specific media. Different epidemiological factors and risk factors were assed and compared to find association of risk factors to visual acuity in fungal keratitis.
Results: Out of total 295 cases of culture-proven keratomycosis at our institute during the study period between June 2010 and March 2015, 254 cases were included in the analysis. In our study most of the patients (61.42%) were male, significant number of patients were from lower socio economic status (89.76%) and from rural background (91.34%). Illiteracy was one of the major factor was found in our patients (85.04%). 48.03% study subjects were having history of ocular trauma while 7.87% patients were Diabetics. Other factors responsible for poor visual outcome were patients age (age > 40 years in 66.15%), delayed Presentation ( > 7 days ,82.22% ), use of topical steroids (90.63% ) and TEM (80.00%), patients having infection caused by septate fungi (74.36%) , hypopyon (89.19%) and central corneal ulcer(78.74%) . Factors could not be assessed in 2 patients less than 1 year of age, so their visual acuity was not recorded.
Conclusions: History of trauma, use of topical steroid, diabetes, lid margin disorders are major predisposing factors for fungal keratitis. Age > 40 years, steroid use, late presentation, central location of ulcer with hypopyon and use of traditional eye medication (TEM) were major risk factors for poor visual acuity with corneal opacity beung most common complication.

How to cite : Deshmukh S, Pandey S, Maurya R P, Singh M K, Singh V P, Yadav I, EPIDEMIOLOGY AND FACTORS AFFECTING VISUAL ACUITY IN FUNGAL KERATITIS IN EASTERN UTTAR PRADESH. Indian J Clin Exp Ophthalmol 2015;1(2):68-75

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