Pediatric microbial keratitis in Taiwanese children: a review of hospital cases.
OBJECTIVE
To study the clinical and microbiological characteristics of pediatric microbial keratitis in Taiwan.


METHODS
The medical records of 81 eyes with microbial keratitis in 78 children aged 16 years or younger who were diagnosed and treated at Chang Gung Memorial Hospital, Taipei, Taiwan, from July 1, 1998, through December 31, 2002, were retrospectively reviewed. Predisposing factors, microbial culture results, clinical course, and visual outcomes were analyzed.


RESULTS
Predisposing factors were contact lens wear (33 cases [40.7%]), trauma (17 cases [21.0%]), ocular disease (12 cases [14.8%]), and systemic disease (9 cases [11.1%]). Eight of the 33 contact lenses were rigid gas-permeable lenses that were worn overnight for orthokeratology. Forty-seven (58.0%) of the 81 eyes were culture positive. The most common isolates were Pseudomonas aeruginosa (21 eyes [44.7%]) and Staphylococcus aureus (9 eyes [19.1%]). Twelve (14.8%) of the 81 eyes required surgical intervention. Of the 68 eyes that had a best-corrected visual acuity available at the last follow-up, 33 eyes achieved best-corrected visual acuity of 20/25 or better.


CONCLUSIONS
Predisposing factors for pediatric infectious keratitis vary with age. In the teenage years, the most predominant risk factor is contact lens wear. Infectious keratitis resultant from overnight orthokeratology lenses should receive particular attention. Parents of children who consider overnight orthokeratology should evaluate the benefit of temporary myopia reduction and the risk of infection. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment of pediatric microbial keratitis.
Hsiao
Ching-Hsi
CH
Department of Ophthalmology, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, No. 199 Tung-Hwa North Road, Taipei, Taiwan.
Yeung
Ling
L
Ma
David H K
DH
Chen
Yeong-Fong
YF
Lin
Hsin-Chiung
HC
Tan
Hsin-Yuan
HY
Huang
Samuel C M
SC
Lin
Ken-Kuo
KK
D000293:Adolescent; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003320:Corneal Ulcer / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D015821:Eye Infections, Fungal / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents