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Research Article | Volume 9 Issue :4 (, 2019) | Pages 46 - 53
Aetiological diagnosis of Bacterial keratitis and its risk factors: A Prospective Study
 ,
1
Assistant Professor Department of Ophthalmology Nootan Medical College & Research Centre, Gujarat
2
Assistant professor Department of Ophthalmology. RVM Institute of Medical Sciences and Research Centre, Telangana
Under a Creative Commons license
Open Access
Published
Nov. 29, 2019
Abstract

Introduction: Bacterial keratitis is also often referred to as a 'corneal ulcer'. In practice, these terms are not directly interchangeable because a cornea may harbor a bacterial infection (i.e bacterial keratitis) without having a loss of tissue (an ulcer) and a cornea may have an ulcer without a bacterial infection. Bacterial keratitis is a serious bacterial infection of the cornea which can, in severe cases, cause loss of vision. Materials and Methods: This is a prospective study conducted over a period of six months at the Department of Ophthalmology. Inclusion Criteria: Patients above the age of 18 years presenting with suspected corneal ulceration and having symptoms of pain, redness, watering, photophobia and decreased vision were included in the study. Exclusion Criteria: Patients with typical features of viral infection and healing ulcers were excluded as were Mooren's ulcers, interstitial keratitis, sterile neurotropic ulcers, and any ulcer associated with autoimmune conditions. Results: Total 90 patients were enrolled with a corneal infiltration that was clinically compatible with the diagnosis of bacterial corneal ulcer. Majority of them were male 54 (60%) and female 40%. The age of patients ranged from 1 to >60 years. Majority of 21-40 years age group (41.1%). The keratitis was induced by foreign body particles were most common risk factor 24.4%. Corneal localization of the ulcers was distributed as in 51 (56.6%) patient's central and in 39 (43.3%) peripheral. The diameter of the corneal ulceration was of 1-2 mm in 24 (26.6%), 3-4 mm in 29 (32.2%), 5-6 mm in 21 (23.3%), 7-8 mm in 9 (10.0%) patients, 7 (7.7%) patients had entire corneal involvement. Ulceration depth was less than 1/3 conreal thickness in 46 (51.1%), between 1/3 to 2/3 in 26 (28.8%) patients and over 2/3 in 18 (20.0%) patients. Anterior chamber inflammation was absent in 9 (10%) patients. A1+ to 2+ Tyndall effect with 1+ to 2+ cells were present in 17 (18.8%) patients, and severe anterior chamber inflammation (3+ to 4+ Tyndall effect and cells, with or without hypopyon) was present in 64 (71.1%) patients. Conclusion: Bacterial Corneal ulcers are a vision-threatening ocular emergency. It is imperative that health care providers across specialties work together so that these patients may have the best possible outcome and avoid the many potential complications.

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