inflamation session - All India Ophthalmological Society

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INFLAMMATION SESSION305ResultsTable-1: Baseline characteristicsCriteria No of patients (%) TotalMaleFemaleSex ratio 958 (51.26%) 911(48.74%) 1869Age group (in years)0-10 0 0 011-20 29 (03.03%)) 21 (02.31%) 50 (2.68%)21 – 30 133 (13.88%) 129(14.16%) 262 (14.02%)31-40 491(51.25%) 442 (48.52%) 933 (49.92%)41 – 50 198(20.67%) 183(20.09%) 381(20.39%)> 50 107(11.17%) 136(14.93%) 243(13.02%)Geographic distributionRural 823 (57.19%) 616(42.81%) 1439(76.993%)Urban 226(52.56%) 204(47.45%) 430(23.007%)Table -2: Major predisposing factorsNo. of cases% of total casesTrauma 1271 68.004Foreign body 04 (0.21%)Coexisting ocular disorder 429 (22.95%)Coexisting systemic disease 156 (08.35%)Inadvertent use of topical steroids 09 (0.48%)Table-3: Nature of traumaNo. of cases % of trauma cases % of total casesVegetative matter 543 42.72% 29.05%Animal matter 211 16.06% 11.29%Sand / stone 209 16.44% 11.18%Dirt 221 17.39% 11.84%Miscellaneous 87 6.85% 4.65%Table-4: Response to treatment and complication as assessed after 3 weeks of therapyNo. of Cases Favourable Complicationresponse (%) No response (%) Perforation (%) Endophthalmitis (%)Fungal (843) 583(69.16) 33(3.91) 192(22.78) 35(4.15)Bacterial (587) 394(67.12) 42(7.16) 122(20.78) 29(4.94)Mixed (124) 72(58.06) 31(25) 12(9.67) 09(7.26)Acanthoembea (06) 05(83.33) 01(16.67) - -No growth (309) 141(45.63) 121(39.16) 32(10.36) 15(4.85)Total (1869) 1195 (63.94) 228 (12.19) 358 (19.15) 88 (4.71)DiscussionIn our study males (51.26%) were affected morethan females (48.74%) most commonly between31-50 years (70.31%), may be due to moreinvolvement of males in field activities mostly inrural areas (73.93%). Trauma with vegetativematter is the major predisposing factor andresults in maximum number of fungal keratitiscases (54.33% of total cases). Chronicdacryocystitis is the major ocular disorderleading to more number of bacterial ulcer(21.64% of total cases). DM results in 6.4% of totalfungal cases and is the major systemic associationof corneal ulcer (97 of 157 cases, 62.18%).
306 AIOC 2009 PROCEEDINGSTable-5: Microbial isolates (as per culture / smear reports)Fungus No. of cases(843) % of Isolate % of total cases (45.10%)Aspergillus Sp. 498 59.075 26.645Fusarium Sp. 249 29.537 13.323Candida Sp. 84 9.964 4.494Penicillium Sp. 12 1.424 0.642Bacteria Cases(587) % of Isolates % of total cases (31.41%)Staphylococcus Sp. 313 53.322 16.747Streptococcus Sp. 175 29.813 9.363Pseudomonas 59 10.051 3.157E. Coli 19 3.237 1.017Gr. +ve bacilli 21 3.578 1.124Mixed bacterial and fungi 124 - 6.635Acanth oemba 06 - 0.321No definite growth pattern 309 - 16.533Aspergillus is the most common fungal isolatefollowed by Fusarium (59.08% Vs 29.54%) andstaphylococcus. Sp. is more common in bacterialulcer (53.32% of bacterial isolates). Fungusisolated from 45.10% cases Vs 31.41% of bacterialisolates. This proportionate difference may bedue to cultural characteristics of fungus as wellas the role of humidity and temperature inmicrobial growth.Response to treatment was favourable in 63.94%of cases and only 19.15% of patients went toperforation indicating that an early intervention1. Whitcher JP, Srinivasan M, Updhyay MP. InEpidemiology of Eye Disease. Longon Arnold,2003;2:190-5.2. Who reports: 1988.3. Bharati MJ et al. Aetiological diagnosis of microbialkeratitis in South India. A study of 1618 cases. IndianJ. Med. Microbiology 2002;20:19-24.4. Bharathi MJ et al. Epidemiology of bacterial keratitisin a referral centre in India. Indian J. Med. Microbiol.2003;21:239-45.5. Bourcier T et al. Bacterial Keratitis, predisposingTuberculosis (TB) is a communicable diseaseand is a leading infectious cause of morbidityand mortality. 1 Ocular tuberculosis encompasesany infection by mycobacterium tuberculosis orone of the three related species (sp. bovis,Referencesmay retard the progression of corneal ulcer todreadful complications.An epidemiological study supported by standardmicrobiological services will definitely aid inearly detection and effective management ofcases of microbial keratitis. A step forward toincrease the awareness about ocular hygiene andocular diseases in rural population will haveencouraging results in the attempt to reduce themorbidity in such cases and the global burden ofblindness as a whole.factors, Clinical and microbiological review of 300cases. Br. J. Ophth. 2003;87: 805-6.6. Dahlgren MA et al. The clinical diagnosis ofmicrobial Keratitis. Am. J. Ophth. 2007; 143: 940-4.7. Burd EM et al. The corneal scientific foundationsand clinical practice. Boston Little Brown andCompany 1994;3:115-124.8. Bharathi MJ et al. Epidemiological characteristicsand laboratory diagnosis of fungal keratitis. A threeyear study. Indian Journal of Ophthalmology2003;51:315-21.Diversity of Clinical Presentation of Ocular TuberculosisDr. Neha Mithal, Dr. Sandeep Mithal, Dr. Charu Mithal, Dr. Sanjay Sharma,Dr. Alka Gupta, Dr. Priyanka Garg(Presenting Author: Dr. Neha Mithal)africanum and microti ) in, on or around the eye.India has 30% of the total number of infectedpeople in the World and TB is a leading cause ofdeath as an infectious killer in India (WHOreport, 1999). However, even in an endemic
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