STUDY OF CLINICAL PROFILE AND RISK FACTORS OF INFECTED CORNEAL ULCERS AT RURAL TERTIARY CARE HOSPITAL

Saurabh Kapase, Shubhangi Nigwekar
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Abstract

Introduction: A corneal ulcer is a discontinuation in normal epithelial surface of cornea associated with necrosis of the surrounding corneal tissue. It is a major worldwide cause of preventable corneal blindness that is mostly under-reported but can be responsible every year for 1.5–2.0 million new cases of monocular blindness. Detailed studies of severe sight-threatening infectious keratitis are therefore important as they provide valuable information on the detection of etiology, predisposing factors, and visual outcomes to form the development of management strategies and protocols. Aims and Objectives: To study the clinical profile and known risk factors of infected corneal ulcers at rural tertiary care hospital. Materials and Methods: An Observational, Descriptive Cross-Sectional Hospital-based study was conducted after Institutional Ethical Committee (IEC) at the Department of Ophthalmology, DVPRMC, Loni. A total of 70 patients with infected corneal ulcers were screened and evaluated from June 2022 to May 2023 for a duration of 1 year. We studied the infected corneal ulcer patients above 18 years old attending to our hospital OPD. Results: 57% of patients were male and 43% were female. 66% of patients gave a history of trauma. The most common clinically diagnosed ulcer was fungal, representing 53% of all ulcers, followed by bacterial (27%) and viral (13%). There were also 2 cases each of acanthamoeba (3%) and pythium (3%) ulcers. 62.8% of cases were above 50 years old. In our study 73% of suspected fungal corneal ulcers were KOH smear-positive and 70% of suspected bacterial corneal ulcers were gram-positive. All cases were advised medical management. Out of those 43% were also advised therapeutic penetrating keratoplasty. Conclusion: Corneal ulcers are commonly seen in adult male farmers and laborers with ocular trauma in rural areas and fungal ulcer is the most common type of ulcer. Late presentation with corneal perforation requires therapeutic penetrating keratoplasty.
研究农村三级医院感染性角膜溃疡的临床概况和风险因素
导言:角膜溃疡是角膜正常上皮表面的中断,伴有周围角膜组织的坏死。角膜溃疡是导致可预防性角膜失明的一个主要原因,在世界范围内,角膜溃疡大多未得到充分报道,但每年可导致 150 万至 200 万例新的单眼失明病例。因此,对严重危及视力的感染性角膜炎进行详细研究非常重要,因为这些研究可提供有关病因检测、诱发因素和视觉结果的宝贵信息,从而制定管理策略和方案。目的和目标:研究农村三级医院感染性角膜溃疡的临床概况和已知风险因素。材料与方法:在洛尼 DVPRMC 眼科的机构伦理委员会 (IEC) 批准后,进行了一项观察性、描述性横断面医院研究。从 2022 年 6 月到 2023 年 5 月,共筛查和评估了 70 名感染性角膜溃疡患者,为期 1 年。我们对在本院手术室就诊的 18 岁以上感染性角膜溃疡患者进行了研究。结果57%的患者为男性,43%为女性。66%的患者有外伤史。最常见的临床诊断溃疡是真菌性溃疡,占所有溃疡的 53%,其次是细菌性溃疡(27%)和病毒性溃疡(13%)。另外,棘阿米巴溃疡(3%)和脓菌溃疡(3%)各占 2 例。62.8%的病例年龄在 50 岁以上。在我们的研究中,73%的疑似真菌性角膜溃疡呈 KOH 涂片阳性,70%的疑似细菌性角膜溃疡呈革兰氏阳性。所有病例都被建议接受药物治疗。其中 43% 的病例还被建议进行治疗性穿透角膜移植术。结论角膜溃疡常见于农村地区遭受眼外伤的成年男性农民和工人,真菌性溃疡是最常见的溃疡类型。晚期出现角膜穿孔时需要进行穿透性角膜移植手术。
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