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Case Studies | Ophthalmology | India | Volume 13 Issue 8, August 2024 | Popularity: 5.7 / 10

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A Study of Epidemiological and Clinical Profile of Fungal Keratitis in a Tertiary Eye Care Centre

Dr. Radhika Darak, Dr. Namrata S Kabra, Dr. Madhur Maniyar, Dr. Trushal Solanke

Abstract: When it comes to the eye, fungi are opportunistic because, unlike some virulent bacterial species, they rarely infect healthy, intact ocular tissues. Ocular fungal infections are increasingly being recognized as a significant cause of morbidity and blindness, particularly in developing countries and tropical regions. In this study Out of 100 subjects, 57% were males and 43% were females, This indicates a male predominance. Maximum subjects were from age group of >60 years (32%) followed by 31-40 years (22%) and 51-60 years (20%). The minimum subjects were from the age group of 10-20 years (2%).68% of the subjects in the present study were farmers while 19% were housewives. Trauma was the primary predisposing factor for most patients with mycotic keratitis. Corneal trauma with an organic or herbal substance has been considered the predominant predisposing factor affecting 40?60% of patients with mycotic keratitis. In the present study; redness, watering, photophobia, discharge, pain and diminution of vision was reported among 80%, 82%, 62%, 39%, 48% and 16% of the subjects respectively. Diabetes mellitus was revealed in 7% of the subjects while 4% of the subjects were suffering from hypertension. Aspergillus was found more in diabetic cases while fusarium in hypertensive. Mild, moderate and severe corneal ulcer grading was revealed in 28%, 32% and 40% of the subjects respectively. Statistically significant association was found between presentation since trauma/symptoms according to severity of corneal ulcer as p<0.05. The most common organism isolated was fusarium (48%) followed by aspergillus (40%). Aspergillus viz. Niger, fumigatus and flavus was found among 23%, 12% and 5% of the subjects respectively in this study. Approximately equal amount of improvement in visual acuity was found in Fusarium (p value 0.027%) and Aspergillus ( p value 0.046) cases i.e. statistically significant.15 subjects were lost to follow up. Healed with scarring, progressed with need for keratoplasty and adherent leucoma was reported among 65%, 18% and 2% of the subjects respectively. Out of 48 cases of Fusarium; 32 subjects healed Statistically significant association was found between presentation since trauma/symptoms according to severity of corneal ulcer as p<0.05ith scarring while 9 progressed with need for keratoplasty. Out of 40 cases of Aspergillus; 25 subjects healed with scarring while 7 progressed with need for keratoplasty. This study explores the epidemiological and clinical characteristics of fungal keratitis among 100 patients at a tertiary eye care center in Central India. The study identifies a significant male predominance and highlights the age groups most affected. It examines the role of corneal trauma as a leading predisposing factor and provides a detailed analysis of the microbial organisms involved, primarily Fusarium and Aspergillus. The findings underscore the importance of early diagnosis and intervention in improving visual outcomes and reducing the need for surgical procedures such as keratoplasty.

Keywords: fungal keratitis, corneal trauma, Fusarium, Aspergillus, visual outcomes

Edition: Volume 13 Issue 8, August 2024

Pages: 1145 - 1147

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