Predictors of Clinical Outcome of Ulcerative Keratitis in a Tertiary Hospital

Aims and objectives: To determine the predictors of clinical outcome of ulcerative keratitis at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Methods: This was a hospital-based study of 61 patients with ulcerative keratitis. Participants’ sociodemographics and clinical information were obtained. Outcome measures included treatment outcome (categorized into good treatment outcome and poor treatment outcome) and posttreatment visual outcome (categorized into visual acuity 6/60 or better and visual acuity worse than 6/60). Results: A total of 61 patients were recruited for the study. Of these, 44 (72.1%) were males and 17 (27.9%) were females. Although majority 55 (90.1%) of the ulcers healed, many developed complications such as perforation with evisceration − 3 (11.5%), panopthalmitis with evisceration − 3 (11.5%), healed perforated ulcers with visually significant adherent leukoma − 5 (19.2%), visually significant corneal opacities from ulcers that healed without perforation − 6 (23.1%), corneal vascularizattion − 7 (26.9%), and anterior staphloma − 2 (7.7%). Predictors of poor treatment outcome included duration of symptoms of more than 1 week, use of harmful traditional eye medictions (TEMs), size of ulcer ≥4mm, and presence of hypopyon. Significant predictors of poor posttreatment visual outcome included age 40 years and above, size of ulcer ≥4 mm, and duration of symptoms ≥1 week. Conclusions: Majority of the corneal ulcers healed. However, many also had complications that led to significant visual impairment and ocular morbidity. These are largely due to late presentation and indiscriminate use of TEMs. Effective eye health education and promotion are recommended to encourage early presentation, prevention, and reduction of visual and ocular morbidity from ulcerative keratitis.