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Microsporidial keratoconjunctivitis: a clinical microbiological review

Session Details

Session Title: Cornea Medical

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:06

Venue: Elicium 1 (First Floor)

First Author: : S.Brar INDIA

Co Author(s): :    J. Masceranhas   L. Prajna   V. Prajna        

Abstract Details

Purpose:

To report a series of 187 healthy individuals who presented with microsporidial keratoconjunctivitis in a tertiary eye care centre in South India.

Setting:

Department of Cornea, Aravind Eye Hospital, Madurai

Methods:

Medical records of all cases of microbiologically confirmed microsporidial keratoconjunctivitis, who presented between November 2011 to October 2012 were retrieved and retrospectively analysed

Results:

The mean age at presentation was 36.2 +/- 14.3 years, range(7-75 years), male to female ratio was 1.22 .Disease was unilateral in 95.7% cases, while 4.3% had bilateral involvement. The mean duration of symptoms was 6.4+/- 3.7 days . 31.5 % reported exposure to foreign body, mainly contamination with mud ( 23.3%) . 103(55%) were already on some form of treatment prior to presentation. All patients had conjunctivitis on clinical examination with coarse, multifocal, punctate epithelial keratitis which was treated with topical fluconazole eye drops and ciprofloxacin eye ointment in majority (92%) of cases after scraping and microbiological confirmation of microsporidia spores with Grams and Calcofluor white +KOH stains. In the subsequent course of disease,11.2% cases had anterior uveitis which was treated with mild steroids and resolved without sequelae. The mean time taken for complete resolution of the disease was 16.6+/- 8.7 days ( while 39.6%were lost to follow up. There was no difference in the mean visual acuity at presentation (6/9)and after resolution (6/9).

Conclusions:

There is a need for increased awareness amongst ophthalmologists to recognize microsporidia as a cause of unilateral, atypical punctate keratitis with conjunctivitis in healthy individuals . Treatment with topical fluconazole and ciprofloxacin is generally successful with satisfactory outcomes.

Financial Interest:

NONE