1Professor, P.I.M.S., Pondicherry
2Associate Professor, Dept. of Ophthalmology, Sri Muthukumaran Medical College, Chennai
The purpose of this study is to determine predisposing risk factors, microbiological profile and visual and structural treatment outcome of non viral microbial keratitis in children.
A prospective case study of 52 eyes with microbial keratitis in a tertiary care teaching institute over a period of two years in children <16 years of age. Data was analyzed for patient demographics, culture data, management trends and visual and structural outcome of treatment.
Mean age of patients was 8.22 years ranging from 7 days to 14 years. The most common predisposing risk factor was trauma (57.69%), followed by malnutrition/Vitamin A deficiency (7.69%) unidentified causes accounted for 30.76% of cases. Cultures were taken from all patients. A total of 55.76% of eyes were culture positive. Bacterial isolates were seen in 30.76% of eyes, followed by fungi in 25% of the culture positive isolates. No growth in 44.23% of patients. Gram positive cocci(predominantly Staphylococcus aureus) were seen in 11.53% of isolates, and gram negative bacilli (predominantly Pseudomonas aerugionosa) in 19.23%. Fungi were identified in 25% of culture positive eyes with equal number of Aspergillus and Fusarium sp. Monotherapy with broad spectrum antibiotics was the preferred treatment. Final visual acuity on last follow up was < 6/60 in 20 eyes (62.5%) One patient each required therapeutic keratoplasty, conjunctival hooding and cyanoacrylate glue with bandage contact lens.
Trauma was the predominant risk factor for microbial keratitis with Pseudomonas aeruginosa being the most common microorganism isolated. Majority of the cases responded to medical management.
Etiology, Bacteria, Fungi, Keratitis, Management, Visual outcome
