Aetiology And Predisposing Factors For Supparative Corneal Ulceration In Nepal

1. Dr Meenu Chaudhary
2. Dr Swapnil Taori
3. Prof D N Shah
4. Dr Sushma Ojha

B.P.Koirala Lions Center for Ophthalmic Studies, TUTH, Maharajgunj, Kathmandu, Nepal

Purpose: To study the epidemiological characteristics, specific pathogenic organisms and risk factors predisposing to corneal ulceration in Nepal.

Method: All patients with infectious corneal ulceration presenting to B.P. Koirala Lions Centre for Ophthalmic Studies, TUTH, Kathmandu (01 Jan 2009-30 June 2010) were evaluated. Sociodemographic data and risk factors were evaluated and slit lamp examination and corneal scraping was performed.

Results: 171 patients with corneal ulceration were evaluated. 97 (57%) patients were females and 74 (43%) were males. Farmers and housewives were the two most common sub group's comprising123 (71.92%). 84 (49.12%) patients presenting with corneal ulcer were found to be illiterate .Ocular trauma was present in 72 (42%) patients. Corneal ulcers were more common in winter (November - January) and in rainy season (June-July). Culture positivity was seen in 95 (55.55%) patients .68 (71.58%) had single bacterial growth, 25(26.32%) had single fungal growth, 1 (1.05 %) had mixed growth of two bacteria and 1 (1.05%) had mixed growth of bacteria and fungi. The most common bacterial pathogen isolated was Streptococcus pneumoniae in 40 (41%).

Conclusion: Corneal ulcers were more frequently seen in middle aged females involved in agricultural work in rural areas. Increased numbers of cases were seen in winter and rainy seasons, being a season of plantation, reaping and harvestation. Trauma with vegetative material was the most common predisposing factor. Culture positivity was high. Bacteria were more commonly isolated because of cooler temperature .Ninety-five percent of patients healed completely with medical management.