Demographic and Aetiological Profile of Microbial Corneal Ulcer in a Hill State in North India

Abstract

Aim: To ascertain the demographic and aetiological profile of microbial corneal ulcer in Uttarakhand, a predominantly hilly state of North India.
Methods: In this prospective non-randomized study, 180 consecutive patients with suspected microbial corneal ulcer attending the ophthalmology outpatient department of the Himalayan Institute of Medical Sciences, Dehradun, India, were evaluated. Corneal scrapings were taken and subjected to microbiological analysis, including Gram stain, potassium hydroxide wet mount, and bacterial and fungal culture.
Results: Among 180 patients, male sex, prior history of ocular trauma with vegetative materials,and occupation involving outdoor activity, especially agricultural work, were the major risk factors for development of corneal ulcer in the population studied. Forty percent of the ulcers were fungal, 28% were bacterial, 10% showed mixed bacterial and fungal growth, and 5% were viral. The aetiology could not be determined in 17% of patients. Fusarium spp was the most common fungal isolate (87.5%) while Staphylococcus aureus was the commonest bacterial isolate (53%).
Conclusions: Fungal ulcers, especially due to Fusarium spp, were the most common type, followed by bacterial ulcers due to Gram-positive bacteria, especially S aureus. This information may be useful for empirical treatment of patients with corneal ulcer in remote areas, where microbiological diagnostic facilities are often not available.