Aetiology and risk factors of bacterial corneal ulcer

Abstract

Introduction: Bacterial corneal ulcer or bacterial keratitis is an infection of the cornea that is caused by bacteria that causes rapid visual loss and pain. The incidence of microbial keratitis (MK) is variable worldwide with an estimated 1.5–2 million cases of corneal ulcers in developing countries.Materials and Methods: This is a prospective study conducted over a period of six months at the Department of Ophthalmology. Inclusion Criteria: Patients above the age of 18 years presenting with suspected corneal ulceration and having symptoms of pain, redness, watering, photophobia and decreased vision were included in the study. Exclusion Criteria: Patients with typical features of viral infection and healing ulcers were excluded as were Mooren's ulcers, interstitial keratitis, sterile neurotropic ulcers, and any ulcer associated with autoimmune conditions.Results: The keratitis was induced by foreign body particles were most common risk factor 22.3%. Trauma with vegetative material was by far the second most common risk factor; this was encountered in 16 (12.3%) patients. History of non-vegetative trauma in 14(10.7%) patients. Anterior chamber inflammation was absenting in 10 (7.6%) patients. A1+ to 2+ Tyndall effect with 1+ to 2+ cells were present in 30 (23.1%) patients, and severe anterior chamber inflammation (3+ to 4+ Tyndall effect and cells, with or without hypopyon) was present in 90 (69.3%) patients. 102 (77.6%) patients, bacteria were isolated from the corneal smears. Gram positive bacteria isolated, most of them 62 (47.6%) were staphylococcus aureus. Gram negative bacteria were isolated in patients, most of them were pseudomonas and yersina. Conclusion: Bacterial Corneal ulcers are a vision-threatening ocular emergency. It is imperative that health care providers across specialties work together so that these patients may have the best possible outcome and avoid the many potential complications.