Risk factors for pediatric presumed microbial keratitis: a case-control study.
OBJECTIVE
To evaluate risk factors for pediatric presumed microbial keratitis and to describe the clinical picture, microbiologic spectrum, treatment modalities, posttreatment sequelae, and visual outcome in cases of pediatric presumed microbial keratitis.


METHODS
A case-control study design was used to identify the risk factors associated with pediatric presumed microbial keratitis. Fifty cases of fresh corneal ulceration aged 12 years or younger were compared with 50 controls. The study variables included were age, gender, immunization status, nutritional status (weight for height), and socioeconomic status. The clinical presentation of the cases with corneal ulceration, microbiologic spectrum, and treatment modalities also were evaluated. All the cases were followed up for a minimum of 3 months, and the posttreatment sequelae and visual outcome were analyzed.


RESULTS
The mean (+/- standard deviation) age of children with corneal ulceration and controls was 4.8 (+/-3.8) years and 5.1 (+/-2.8) years, respectively. Incomplete immunization status (AOR [95% confidence interval (CI)], 1.34 [0.62-2.9]) and poor nutritional status [AOR (95% CI) 1.06 (0.68-1.6)] were not found to be the predictors of corneal ulceration. Lower socioeconomic status was significantly associated with the occurrence of corneal ulceration [AOR (95% CI) 1.52 (1.1-2.3)]. Corneal trauma (38%) and systemic illness (24%) were the most often associated predisposing factors. Seventy percent of the cases were culture positive. Staphylococcus (70%) species was the most frequently isolated, followed by Pseudomonas aeruginosa (10%). Fungi were isolated in five eyes. Postresolution visual acuity at 3 months could be recorded only in 31 eyes and a visual acuity of 6/18 or better was achieved in 22% of these cases.


CONCLUSIONS
Corneal ulceration in pediatric age group in India is associated with poverty.
Vajpayee
R B
RB
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. rbvajpay@medinst.ernet.in
Ray
M
M
Panda
A
A
Sharma
N
N
Taylor
H R
HR
Murthy
G V
GV
Satpathy
G
G
Pandey
R M
RM
D001827:Body Height; D001835:Body Weight; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003320:Corneal Ulcer / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D015821:Eye Infections, Fungal / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007114:Immunization; D007194:India / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D012307:Risk Factors; D012923:Social Class; D014792:Visual Acuity