Demographic pattern, predisposing factors and management of ulcerative keratitis: evaluation of one thousand unilateral cases at a tertiary care centre

Abstract

Corneal ulcers are a frequent problem in this part of the world. The ulcers seen at this tertiary referral hospital present late in the natural history of the disease and are clinically severe. Despite the severity a majority of the eyes could be saved anatomically, but almost 65% of eyes were left with a visual acuity of <6/120. Considering the high magnitude of visual loss, public education about the potential for loss of sight and the importance of timely and appropriate treatment is recommended.

Clinical and microbiological characteristics of corneal ulcers in a Thai referral center

“…The proportion of positive culture was different in each report, ranging from 30% to 79% [3][4][5][6][8][9][10][11][12][13]. Positive microbial growth has been identified in 52% of corneal scrapes in our study, which was comparable with other studies from referral centers in Thailand, such as Siriraj hospital (51%) [3] and Chulalongkorn hospital (47%) [5].…”

“…Our study had a higher ratio of men to women, which was similar to other studies undertaken in Thailand [1][2][3][4][5][6][7] and several other countries [8][9][10]. This is probably because ocular trauma was the main risk factor in our study and ocular trauma was found to be significantly more common in men than in women (p <0.001).…”

“…Ocular trauma has been identified as the most common risk factor for microbial keratitis in this study, similar to other studies in Thailand [1][2][3][4][5][6][7] and many developing countries [8][9][10][11]. Whereas, in developed countries some studies found that wearing contact lenses was the most common predisposing factor, such as in England [12], Australia [13], and Japan [14].…”

“…This was similar to other studies that found bacteria, rather than fungus. For example, in India bacteria was found in 22% of cases, fungus in 19.7%, and mixed organisms including bacteria and fungus 14% and Acanthamoeba 1.1% [8]. Studies in Bangkok from Siriraj Hospital found bacteria in 53% of cases and fungus in 25% [3], King Chulalongkorn Memorial Hospital found bacteria in 32.5% of cases and fungus in 11.6% [5], Ramathibodi Hospital found bacteria in 60% of cases, fungus in 38%, and Acanthamoeba in 2% [7].…”

“…Several studies from different regions or different times in Thailand have addressed these issues [1][2][3][4][5][6][7]. In developing countries, the most common predisposing factor was ocular trauma [8][9][10][11] while in developed countries, it was found that contact lens wear could be a more common cause [12][13][14]. Common organisms were bacteria and fungus.…”