Blindness due to keratomycosis: problems and management

Session Details

Session Title: Orbis Free Paper session

Session Date/Time: Monday 15/09/2014 | 11:45-12:45

Paper Time: 12:39

Venue: Capital Suite 14 (Level 3)

First Author: : J.Sukhija INDIA

Co Author(s): :    A. Sharma              

Abstract Details

Purpose:

To identify risk factors affecting outcome of mycotic keratitis and barriers for delayed presentation in North India.

Setting:

Tertiary care centre of North India

Methods:

One hundred twenty eight cases (eyes) of laboratory proven fungal keratitis with at least 3 months follow-up or earlier who had a definite outcome were studied. Perforated (>3 mm) corneal ulcers were excluded from the study. Demographic parameters were noted. Delay in presentation was considered if patient presented one week after onset of symptom. Clinical findings were recorded as standard colour coded corneal grid diagrams. The relationship between the epidemiological profile of the patient, the severity of corneal ulceration and the cause of delay in presentation was analyzed using logistic regression, chi-square test and multi variate analysis.

Results:

Mean age of patients was 32.82 years. Majority (32.03%) of them were agricultural workers. Trauma was the most common predisposing factor (55.5%) with maximum cases (14.84%) presenting in the month of December. The barrier for delayed presentation included lack of awareness regarding the severity of the disease (62.74%) followed by hesitancy to travel long distances (10.78%) to seek tertiary care services. Occupation, rural setting and delay in presentation significantly affected the severity of the disease (p<. 05). Severity of the disease significantly affected the outcome (p<. 05). Medical management was successful in 92 (71.88%) patients.

Conclusions:

Delayed presentation and severe disease result in poor outcome and significant ocular morbidity .Therefore, public education to create awareness, high index of suspicion of fungal keratitis on the part of the treating physician and prompt referral if patients do not respond may reduce ocular morbidity.

Financial Interest:

NONE