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Alice Hong, Dipika Joshi, Anna Djougarian, John Seedor, David Ritterband; Trends in Pediatric Corneal Ulcers at the New York Eye and Ear Infirmary. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1464.
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To study the microbiologic profile and clinical risk factors of pediatric corneal ulcers at the New York Eye and Ear Infirmary.
All eligible patients with clinically diagnosed infectious keratitis aged 16 years and younger that presented to the New York Eye and Ear Infirmary during a five year period between January 1, 2005 to May 1, 2010 were retrospectively reviewed. The records were retrieved electronically by diagnosis codes. Microbial culture results and clinical characteristics were reviewed.
75 eyes of 63 children (32 male and 31 female) aged 16 years or younger were analyzed. In the same 5 year time span over 2500 cases of infectious keratitis in all age groups were seen. 66 (88%) eyes were culture positive and 9 (12%) eyes were culture negative. Polymicrobial infections were seen in 22 eyes (29%). A total of 111 infectious agents were identified. 70/111 (63%) were Gram positive organisms and 27/111 (24%) were Gram negative organisms. The remaining organisms were fungal 6/111 (5%) , acanthamoeba 6/111 (5%) and herpes simplex virus 6/111 (5%) . The most common microorganisms in descending order were S. epidermidis (19), P. aeruginosa (17), P. acnes (15), S. aureus (12) and S. viridians (10). The predominant risk factor for infectious keratitis in children was contact lens wear (55%) followed by trauma (15%), ocular surface disease (11%), systemic disease (8%) and previous ocular surgery (4%).
Infectious keratitis in the pediatric age group is uncommon. Contact lens use is the predominant risk factor in the teenage years and trauma continues to be an important risk factor in the younger age group. Recognizing predisposing factors and the microbiologic trends is helpful in prompt and effective treatment in the pediatric population to prevent future complications that may lead vision threatening disease.
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