A cross sectional study on clinico microbiological profile of patients with fungal corneal ulcer attending a tertiary care hospital of Shimoga district, Karnataka

Corneal ulceration is the most common cause of preventable blindness, second only to cataract in developing countries. Mycotic keratitis accounts of 30–62% of all culture positive infectious keratitis in several Indian studies. Mycotic keratitis is a significant problem in a country like India with a predominantly agrarian population, who encounter ocular trauma with vegetative material.

To study the clinical profile of patients with fungal corneal ulcers in relation to age, sex, risk factors, clinical presentation and laboratory diagnosis in the outpatient department of a tertiary care hospital of Shimoga district.

A prospective cross sectional study was carried out on all consecutive patients presenting with corneal ulcer attending the out-patient department of a tertiary care hospital of Shimoga district, Karnataka, between August 2013 to July-2014.

Out of the total 90 cases of corneal ulcer, 30 were fungal culture positive. Out of these 30 cases, males [21, 70%] were affected more than females [P < 0.0001]. The age group most commonly affected was 31–40 years [8, 26.67%], patients [24, 80%] residing in rural areas were more affected and most patients were agricultural workers [19, 63.6%]. Corneal trauma [27, 90%] was the most common risk factor [P < 0.0001] and 17 patients [62.96%] had history of trauma with vegetative matter [P < 0.0001]. Incidence of fungal corneal ulcer was highest during the paddy harvesting season. The sensitivity of 10% KOH wet mount preparation was higher [96.96%] than gram-stained smear [87.88%S] [P < 0.0001].

Fungal culture was positive in 30 cases [33.33%]. The most commonly isolated fungal species was Fusarium species [12 cases, 40%] followed by Aspergillus species [8 cases, 26.66%].

Ocular trauma with vegetative material especially in agriculture workers was an important cause of mycotic keratitis. Direct microscopic examination of KOH wet mount preparation is a rapid, sensitive, technique of laboratory diagnosis in mycotic keratitis. It is particularly important for the early initiation of antifungal treatment.