Multivariate analysis of childhood microbial keratitis in South India.
BACKGROUND
Corneal infection is the most common cause of profound ocular morbidity leading to blindness worldwide. Corneal infection in children is difficult to diagnose and treat, as they are unwilling and sometimes unable to cooperate during active management. This study analyses the prevalence, microbiology, demography, therapeutic and visual outcome of infectious microbial keratitis in the paediatric age group seen at a tertiary eye care hospital in south India.


METHODS
A retrospective review of all cases presenting with keratitis to the ocular microbiology and cornea service at Aravind Eye Hospital, Coimbatore, from February 1997 to January 2004, was done to screen the patients for microbial keratitis. Their records were further analysed for clinical and microbiological details. Cases with culture-proven non-viral keratitis in children <or=15 years were included in the study. Full ophthalmic examination was performed for all cases.


RESULTS
Of the 310 patients who attended the cornea clinic, 97 (31.2%) patients were confirmed to be positive for microbial keratitis. 54.6% of cases were male. The most common predisposing cause of ulceration was trauma (69%) with organic matter. Pure bacterial cultures were obtained from 64 (65.9%) eyes, whereas pure fungal cultures were obtained from 37 (38.1%) eyes. Four (4.1%) eyes showed mixed growth.


CONCLUSIONS
The most commonly isolated organism was Pseudomonas aeruginosa. The most common predisposing cause of infectious microbial keratitis was corneal trauma. Early stage of diagnosis and formulation of an uncompromising management protocol can prevent profound visual morbidity.
Singh
Gurdeep
G
Pediatric Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India. micro@cbe.aravind.org
Palanisamy
Manikandan
M
Madhavan
Bhaskar
B
Rajaraman
Revathi
R
Narendran
Kalpana
K
Kour
Avneesh
A
Venkatapathy
Narendran
N
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000628:therapy / Q000635:transmission; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000628:therapy / Q000635:transmission; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D008297:Male