Prateek Jain1, Sushma Kumari Singhal2, Pankaj Sharma3, Kalika Gupta4
BACKGROUND
Significant causes of corneal blindness worldwide are ocular trauma and corneal
ulceration that are often under reported. They may be responsible for 1.5 - 2.0
million new cases of monocular blindness every year. Corneal ulceration in
developing countries has only recently been recognised as a silent epidemic.
Infectious keratitis is one of the leading causes of blindness but in most cases
these infections represent preventable or treatable ophthalmic diseases. Important
predisposing factors related to corneal ulcers are trauma, chronic ocular surface
disease, contact lens usage, ocular surgery, corneal anaesthetics abuse, diabetes
mellitus, vitamin deficiency and immuno-deficiencies. This work is proposed to
study the prevalence, clinical and lab diagnosis and management of suppurative
corneal ulcer. We wanted to study the socio-demographic profile, microbiological
investigation and treatment outcome of patients with corneal ulcer.
METHODS
This is a prospective study conducted among patients presenting with corneal ulcer
at a tertiary level Government Medical College, Ajmer, Rajasthan.
RESULTS
Trauma comes out as a major predisposing factor for the development of corneal
ulcer. 18.1 % of the study subjects had bacterial corneal ulcer and 37.7 % had
fungal ulcer. More than half of the patients showed good prognosis on follow up.
There was good response in most of patients, 51.2 % improved in first week which
increased to 57.4 % at the time of second follow up. The most common bacterial
species responsible for corneal ulcer was found to be staphylococcus followed by
pseudomonas.
CONCLUSIONS
Bacteria and fungi are a frequent cause of ulcerative keratitis. Microbiological work
up is an essential tool in the diagnosis of these infections which should not be
under-rated. Timely administration of species-specific treatment certainly results
in early resolution of keratitis followed by satisfactory visual outcome. Late or
inappropriate treatment worsens the condition resulting in corneal perforation and
increased morbidity.
