Mycotic Keratitis in Solapur (A Two Years Study)

Abstract

ntroduction: Corneal ulcer is the second most common cause of visual disability and blindness in developing countries after cataract. Corneal scarring due to keratitis can be prevented. This therefore necessitates the knowledge of its etiology for early intervention. Aim: To study the occurrence, etiology and predisposing factors of mycotic keratitis at a tertiary care centre in Solapur, Maharashtra. Materials and Methods: The retrospective study was carried out for duration of 2 years (April 2013 to March 2015). All aseptically collected corneal scrapings from clinically suspected cases of fungal keratitis were included. Conventional methods i.e. KOH mount, Gram’s stain and fungal cultures on a pair of Saubaraud Dextrose Agar were used for diagnosis. Slide cultures on Corn Meal Agar with tween 80 were used for confirmation of moulds and germ tube tests done for yeasts. Results: Hundred corneal scrapings were studied out of which fungal hyphae were identified in 20% of the KOH mounts and in 17% of Gram’s stained smears. Fungal culture was positive in 24 samples. Predominant isolate was Fusarium spp (29%. 7/24) followed by Alternaria spp (21%, 5/24) and Aspergillus spp (17%, 4/24) and 8% (2/24) each of Cladosporium spp, Penicillium spp, Bipolaris spp and Candida albicans. Ocular injury was the most commonly encountered predisposing factor. Conclusion: Fungal aetiology constitutes a significant proportion of corneal ulcers, out of which Fusarium spp is the most common isolate in Solapur, Maharashtra followed by Alternaria spp unlike majority of studies in the country where Aspergillus spp are the most common isolates.

Keywords

• corneal scrapings
• fungal culture
• fungal isolates
• microscopy