Outcome of Management of Infective Keratitis in Varied Etiology and Severity

Introduction: Infective keratitis, a major cause of monocular corneal blindness, is an ocular emergency that requires proper and timely management. There are many causes of microbial keratitis such as bacterial, viral and fungal. Bacterial keratitis is the most prevalent amongst microbial keratitis. Fungal keratitis possesses a clinical challenge due to its overlapping features and potential complications. The knowledge of risk factors and clinical characteristics of various keratitis along with its determinants will certainly help in early diagnosis and overall reduction in visual morbidity associated with it.

Purpose: The purpose of the study is to identify epidemiology, risk factors, aetiology, response to treatment and expected outcome in cases with infective keratitis.

Results: Infective keratitis was seen commonly in middle aged, male, field workers with fungal etiology. Microbiological reports helped to know causative organism and to start appropriate medical management. Non-responding cases after 1 week (13cases) required modification of treatment in the form of fortified drops as per culture and sensitivity, chemical cautery and in presence of non-resolving hypopyon, anterior chamber wash with intra-cameral antibiotics. Non-responders or poor responders or patients with complications like non-healing ulcers and corneal perforation then underwent surgical intervention in the form of AMT (amniotic membrane transplant) and corneal transplant.

Conclusion: Our study demonstrates that timely management as per microbiological reports of infective keratitis is feasible, cost effective and achieves expected outcome. Step wise approach, appropriate counselling and regular follow ups reduces complications and thus reduces burden of corneal blindness.

Keywords: Infective keratitis, Culture ,Trauma, Chemical cautery. AMT, keratoplasty.