Epidemiological and Microbiological Profile of Suppurative Corneal Ulcer in a Tertiary Care Hospital in Eastern India

Author(s): Krittika Palchoudhury1 , Sagar Karmakar2 , Chandana Chakraborti3

BACKGROUND Corneal ulcer is an open sore on cornea causing significant morbidity especially in developing countries. It is associated with redness, watering, photophobia, pain and decreased vision of that eye. It is a vision threatening emergency and may lead to corneal scarring and perforation. If left untreated it may progress to endophthalmitis. So, an early diagnosis with recognition of the causative agent is very much essential to preserve vision. We conducted this study to evaluate the risk factors, causative organisms, and patient demographics of microbial keratitis. METHODS All new patients with suspected suppurative keratitis presenting at the ophthalmology OPD of Calcutta National Medical College and Hospital for a period of 1 year were evaluated. Sociodemographic data, visual acuity at presentation, and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping was performed. Microscopy and culture were performed on all corneal specimens obtained. From this data we tried to find out the epidemiological pattern and factors involved in suppurative corneal ulcer. RESULTS One hundred and fifty cases of suppurative keratitis were studied clinically and microbiologically. Study showed a male preponderance (73.33%) with cultivators constituting the major occupational group (29.33%). Trauma was the commonest pre-disposing factor (64%). Among the 114 (76%) culture positive cases, 62 (41.33%) patients had pure fungal infection, 33 (22%) patients had pure bacterial infections and 19 cases (12.67%) had mixed fungal and bacterial infections. Aspergillus spp. were the most common fungal isolate, while among the bacteria positive cases, the main isolates were Staphylococcus aureus, Pseudomonas sp. and Pneumococcus. CONCLUSIONS Suppurative corneal ulcer is an important cause of preventable blindness. Smear and culture is an essential tool in the diagnosis of these infections. Region based information about the causative organisms and risk factors helps in empirical management, and to formulate guidelines for prevention of suppurative keratitis in the population at risk.