inflamation session - All India Ophthalmological Society

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INFLAMMATION SESSION3033. Cases referred from infectious diseasehospital.4. Cases referred from the department ofObstetrics and Gynecology.5. Persons who voluntarily want to know HIVstatus.6. Female sex workers.7. Intravenous drug abusers8. Truck drivers and migrant population.9. Cases referred by NGO ( Ship, Rotary, Lions)10. Cases whose spouse tested to be HIVpositive.11 Children of HIV positive parents.12. Professionals ( Doctors, Nurses, Labtechnicians, Blood bank workers who reportafter accidental needle prick.)1466 clients who came for HIV testing to ICTCwere subjected to Tridot test. 595 (40.58%) whoturned out to be HIV positive were screened forocular involvement after taking informedconsent. They were tested for Visual acuity, Slitlamp examination, Direct and indirectOphthalmoscopy at the department ofOphthalmology of Guntur Medical college.ResultsOut of 595 HIV positive cases 119 (20%) werefound to be having Ocular involvement. Of 595HIV positive cases 352 (59.15%) were males and243 (40.84%) were females. Among those whowere having ocular involvement 71 (59%) weremales and 48 (41%) were females. Various ocularComparison of StudiesOcular lesion Awan et al Jabs et al Biswas et S.K mandal S.P.Sahoo OurKenya USA al India Et al studyMolluscum * * * * 1.5% 3.36%Herpes Zoster * * * * 4.54% 5.04%Orbital Lymphomas * * * * * 1.68%OSSN * * * * * 9.24%Dendritic ulcer * * * * * 1.68%Fungal ulcer * * * * * 0.84%Iridocyclitis * * * * 4.5% 52.94%Choroiditis * 3% * 0.57% * 2.52%CMV retinitis 3% 4.7% 17% 10.6% 11% 10.92%HIV retinopathy 25% 6.4% 15% 10.65% 12% 9.24%Optic atrophy 3% 5% 7% 3% 3% 0.84%lesions seen were as follows:Ocular lesions No. of cases %(119) of casesMolluscum Contagiosum 4 3.36%Herpes zoster ophthalmicus 6 5.04%Orbital Lymphomas 2 1.68%OSSN 11 9.24%Dendritic ulcer 2 1.68%Fungal keratitis 1 0.84%Iridocyclitis Ac/Ch 63 52.94%Choroiditis 3 2.52%CMV Retinitis 13 10.92%HIV retinopathy 11 9.24%Optic Atrophy 1 0.84%DiscussionThe incidence of iridocyclitis in our study is morewhen compared to other studies. The casesreferred to ICTC were more from department ofSTD and TB and chest diseases. As it is wellknown fact that iridocyclitis is commonly seen inpatient suffering from Syphilis and Tuberculosis.The clients attending ICTC were in majorityreferred by clinicians on suspicion of havingAIDS. And most of the positive cases were fromthat group. The categories from 5 to 11 wereeither referred by voluntary organizations or theclients themselves came for testing on creation ofawareness about AIDS by Govt. or NGOorganizations.
304 AIOC 2009 PROCEEDINGSAUTHORS’S PROFILE:DR. SAMIR MAHAPATRA: M.B.B.S (2003), SCB Medical College, Utkal University, Cuttack,Orissa; M.S. (Ophth) (2009), V.S.S. Medical College, Sambalpur University, Burla, Orissa.Presently, Final Year PG student, V.S.S. Medical College, Sambalpur University, Burla, Orissa.Contact: 9861192452; E-mail : yourssamir@yahoo.co.inEpidemiological and Microbiological Evaluation of MicrobialKeratitis in Western Orissa: A 2 Year Prospective Study in ATertiary Care CentreDr. Samir Mahapatra, Dr. Debendra Kumar Sahu, Dr. Gunasagar Das, Dr. DebendraNath Bhuyan, Dr. Sharmistha Behera, Dr. Sulin Kumar Behera, Dr. H. Maruthi(Presenting Author: Dr. Debendra Kumar Sahu)Microbial keratitis constitutes the mostcommon and serious ocular infection indeveloping countries having a varied geographicpattern and several predisposition. 1 It is theleading cause of corneal blindness in South Asia. 2All over the world bacterial keratitis is morecommon than fungal keratitis but this does nothold true for India and other tropical countries. 3Among several risk factors of corneal ulcer inour country, trauma to cornea accounts for 60-80% of cases. 4 Clinical diagnosis of infectiouskeratitis is crucial because even establishedlaboratories can grow upto 60-70% of ocularpathogens from the material sent for culture. 5 Theclinical diagnosis of microbial keratitis oftenrelies on a thorough history, especially history ofinfectious exposure, epidemiological trends andthe morphological features of cornealinflammation. Ophthalmologists use clinicalclues to recognize ocular surface infection. Somedistinctive signs, though not pathognomic,unique to the causative organism may help todifferentiate bacterial, fungal and amoebicpathogens of the cornea. 6 The etiological andepidemiological pattern of corneal ulcerationvaries significantly with patient population,health of the cornea, geographic region, climate,age and also tends to vary over time. 7The aim of this study was to evaluatedemographic and epidemiological features andthe prevalence of microbial isolates in cases ofmicrobial keratitis in Western Orissa.Materials and Methods1869 presumed cases of microbial keratitis withunilateral affection were subjected to meticuloushistory taking and thorough ocular examinationunder S/L. Samples were collected by scrapingthe ulcer area under topical anaesthesia usingstandard techniques 8 with a BP blade No.-15.Materials obtained was subjected to smearpreparation on glass slides for 10% KOH mountand Gram’s / Giemsa stain. Rest of the materialwas inoculated into SDA, blood agar, chocolateagar, non-nutrient agar, BHI broth andthioglycollate medium and then sent to Dept. ofMicrobiology for detailed evaluation. Onconfirmation of fungal filaments on 10% KOHmount, antifungal treatment with 5% Natamycinwas started to the respective cases. On negative10% KOH mount, empirical treatment withtopical broad spectrum antibiotic drops wasstarted till confirmatory growth pattern onculture was obtained (usually within 72 hrs)along with antibiotic susceptibility reports. Thespecific antibiotic was instituted and response totherapy was evaluated at the end of 3rd week.This prospective study included all patientsattending the OPD of Dept. of Ophthalmology,V.S.S. Medical College, Burla, Sambalpur fromApril 2006 to May 2008. Data pertaining todemography, epidemiology and clinicomicrobiologicalcharacteristics were analysed. Inthe entire study patient’s compliance andcomfort were assured.
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