PATTERNS OF PRESENTATION OF FUNGAL KERATITIS IN TERTIARY CARE HOSPITAL

Abstract

Uday Sridhar Mulgund1, Ravi Shankar M2, Satish Kumar C.S3

BACKGROUND
Fungal keratitis is one of the major cause of visual loss in developing countries. A contributing factor for the development of fungal infection is ocular trauma and contamination of corneal lesions by soil and vegetative material. Another factor being widespread use of broad-spectrum antibiotics, steroids and contact lens wear. According to the World Health Organization report, it is estimated that ocular trauma and corneal ulceration result in 1.5 to 2 million new patients of corneal blindness annually. In India, the incidence of corneal ulceration is reported to be 1130 per million population. Corneal infection of fungal aetiology is common in India (19-45%). Corneal infection of fungal aetiology is very common and may represent 30 to 40% of all cases of culture-positive infectious keratitis in South India.4 more than 70 species of filamentous fungi have been identified as the aetiological agents of fungal keratitis. Of these, Aspergillus and Fusarium are responsible for 70% of cases.
The aim of the study is to study the-
1. Clinical presentation, contributing and precipitating factors for fungal keratitis and prognosis with regard to the available mode of therapy.
2. Investigations regarding the type of fungus and the statistical significance regarding the common type of fungi that involve the cornea.
MATERIALS AND METHODS
All cases of keratitis that presented were investigated with KOH wet mount and fungal culture. Histopathological diagnosis was made with the report of fungal culture. All cases of fungal keratitis were treated with antifungal and clinically studied in the Department of Ophthalmology, KIMS, Hubli, from 1stJanuary, 2016 - December 2016.
RESULTS
In the clinical study of fungal keratitis, out of 62 cases, suppurative keratitis 30(48.38%) cases were fungal keratitis on clinical suspicion and fungal staining.
CONCLUSION
India being an agricultural country, the incidence of fungal keratitis is significantly high. Fungal keratitis has tendency to progress slowly with minimal symptoms, hence the patients are provoked to apply local native medicines and approach the doctor very late. Lack of laboratory identification especially in peripheral hospital adds to the problem. With timely specific treatment, one can combat the disease efficiently and thus prevent the eye going in for blindness.

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