Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study

• Main Authors: Bharathi Jayahar, Ramakrishnan R, Vasu Samala, Meenakshi R, Palaniappan R
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2003-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Fungal keratitis; microscopy; culture; risk factors; epidemiology
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2003;volume=51;issue=4;spage=315;epage=321;aulast=Bharathi

<b>Purpose: </b> To study the epidemiological characteristics and laboratory diagnosis of fungal keratitis seen at a tertiary eye care referral centre in South India. <b> Methods: </b> A retrospective review of all culture-proven fungal keratitis seen over a 3-year period, September 1999 through August 2002. <b> Results: </b> Fungal aetiology were confirmed in1095(34.4&#x0025;) of 3183 corneal ulcers. The predominant fungal species isolated was <i> Fusarium</i> spp (471; 42.82&#x0025;) followed by <i> Aspergillus</i> spp (286; 26&#x0025;). Males (712; 65.08&#x0025;) were more often affected (P&lt; 0.0001). A large proportion of the patients (732; 66.85&#x0025;) were in the younger age group (21 to 50 years). A majority (879; 80.27&#x0025;) came from rural areas (P< 0.0001), and most patients (709; 64.75&#x0025;) were farmers (P< 0.0001). Ocular trauma (1009; 92.15&#x0025;) was a highly significant risk factor (P< 0.0001) and vegetative injuries (671; 61.28&#x0025;) were identified as a significant cause for fungal keratitis (P< 0.0001). 172 (15.71&#x0025;) patients had concurrent diabetes mellitus. The sensitivity of 10&#x0025; potassium hydroxide (KOH) wet mount preparation was higher (99.23&#x0025;) than Gram-stained smear (88.73&#x0025;) (P< 0.0001). Incidence of fungal keratitis was higher between June and September. <b> Conclusion: </b> Agricultural activity and related ocular trauma were principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis.