A five-year report of pediatric non-viral microbial keratitis in a tertiary eye center.

Abstract

Purpose: To evaluate the demographic data, risk factors, clinical outcomes, microbial spectrum, and treatment in pediatric microbial keratitis cases.

Methods: The medical data including demographics, predisposing factors, accompanying diseases, clinical course, and microbial culture results was retrospectively evaluated. A total of 27 patients younger than 18 years who were diagnosed as microbial keratitis in a tertiary referral center between March 2019 and December 2023 were included in the study.

Results: The male/female ratio was 14/13. The mean age was 13.02 ± 6.21 (range, 2-18) years. The most common risk factor was contact lens use (33.8%) followed by trauma (18.5%). The most common accompanied disease was acne rosacea (7.4%). In 20 cases (with a lesion greater than 2 mm in diameter, involving a layer deeper than half of the cornea, etc.) culture samples were taken. Cultures were positive for microbial growth in 8 (40.0%) patients and Pseudomonas aeruginosa was the most frequently isolated organism (25.0%). While 24 (88.8%) of the keratitis improved with medical treatment alone, additional corneal debridement was applied to 2 (7.4%) eyes, and therapeutic penetrating keratoplasty was performed in one refractory case.

Conclusion: Although rarer than adult cases, pediatric keratitis is an important entity in childhood due to difficulties and complications in history taking, examination and medication use. This study emphasizes the role of contact lens usage and trauma as the primary causes and Pseudomonas aeruginosa as the most frequent microorganism in pediatric keratitis. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment.