Evidence map›Paper›PMID 38676784›Full record

ArticleInternational ophthalmology2024

Microbial keratitis and its management at a rural centre: achieving success with limited resources.

Raksheeth Nathan Rajagopal, Somasheila I Murthy, Varsha M Rathi

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Article in International ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Raksheeth Nathan RajagopalAcademy for Eye Care Education, L V Prasad Eye Institute, Hyderabad, India.
Somasheila I MurthyThe Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute (LVPEI), Kallam Anji Reddy Campus, L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, 500034, India. smurthy@lvpei.org.
Varsha M RathiThe Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute (LVPEI), Kallam Anji Reddy Campus, L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, 500034, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMicrobial keratitis is a sight-threatening condition with a higher incidence in agrarian populations. In countries with a high indigent population, due to financial and other constraints, patients prefer to seek therapy locally rather than travel to advanced centres. The aim of this study is to describe the epidemiology, clinical characteristics, and outcomes of 60 consecutive patients with microbial keratitis managed at a rural centre.

methodsDescriptive case series. All patients clinically diagnosed with infectious keratitis were included. Corneal scrapings were obtained and microbiological identification was done by Gram stain. Anti-microbial therapy was commenced based on smear findings and the patients were followed up till disease resolution.

resultsSixty eyes of 60 patients were diagnosed with microbial keratitis in the study period. The mean age was 47.43 ± 18.69 years. Male:female ratio was 47:53. Risk factors included ocular trauma in the majority of patients (46/60; 76.7%). Microorganisms were identified on 75.6% of smears, with fungal filaments (65.4%) being the most common. Ulcers were central in over half (32/60; 53.3%), and > 3 mm in diameter in over three-fourths (81.6%) of patients. Forty-four patients (73.3%) achieved treatment success whereas 16/60 (26.6%) required referral to our tertiary-eye care facility for management. The median time to resolution was 14 days (IQR 10-26 days).

conclusionOur series demonstrates the feasibility of microbiology-guided therapy in microbial keratitis by ophthalmologists at the secondary rural eye-care level. Two-thirds of the patients could be successfully managed at the rural centre and only severe cases needed a referral to tertiary centres.

Indexed as

Eye Infections, BacterialRural PopulationAdolescentAdultAgedAnti-Bacterial AgentsBacteriaCorneal UlcerEye Infections, FungalFemaleHumansIncidenceIndiaKeratitisMaleMiddle AgedAnti-Bacterial AgentsFungal keratitisMicrobial keratitisOutcomes of infectious keratitisRural eye careSecondary centre

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.