Clinical implication of microbiological evaluation of corneal ulcer and its correlation with outcome: A follow up study from a central Indian tertiary health care center

Abstract

Objective: To find out the incidence of different types of corneal ulcers and outcome of target-specific treatment based on microbiological evaluation. Materials and methods: In a hospital based prospective studies spanning over 2 years, 50 cases of corneal ulcer underwent microbiological evaluation of corneal scrapings and were started on culture-guided antimicrobial therapy. Result: Most ulcers were found to be prevalent in age between 51-70 years. 72 % were males, 28% females, 52% from rural areas, 50% were labourers (agricultural 28% and manual 22%), with ocular trauma and vegetative foreign body being the commonest predisposing factors. Among culture positive cases, 58.6% and 41.4% were positive for fungi and bacteria, respectively. Aspergillus was the most commonly isolated fungal species and Pseudomonas aeruginosa was the most common bacterial isolate. Moxifloxacin and tobramycin were effective in treating a majority of bacterial corneal ulcers, and hence can be considered to be the drugs of choice for the same. Complete healing of corneal ulcer with treatment was seen in 82.8% of culture positive patients. Conclusion: Infective keratitis should be managed as an ophthalmic emergency. Instantaneous administration of culture-guided antimicrobial therapy to patients with infective keratitis can avert disabling ocular morbidity and sequential blindness.