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A. A. Kazi, N. A. Khan, J. Khan, S. Afzal, N. Laghari, I. Parekh; Etiology of Microbial Keratitis at Two Tertiary Eye Care Centers in Hyderabad (Sindh) Pakistan. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4289.
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Ninety patients diagnosed with infective keratitis presenting at either Liaquat University Eye Hospital or the Isra University Hospital, Hyderabad, Pakistan between February and June 2006 were enrolled in the study. A performa was used to identify patient name, age, eye involved, sex, demographics, risk factors, visual acuity at presentation, size and location of infiltrate, presence or absence of hypopyon, and prior use medications or antibiotics. Corneal scrapings were obtained in all eyes and sent for gram staining and KOH smears. The corneal scrapings were also cultured in sheep’s blood agar, and sabouraud’s agar. The eyes were treated empirically with broad spectrum antibiotics and antifungal topical agents with or without atropine.
The average age of our patients presenting with infective keratitis was 41 years, with males: female ratio of 2:1. The majority of the patients presented from rural sindh (65%) as compared urban city dwellers. Fifty percent of the patients presented with hypopyon. Seventy seven (85.5 %) of the ninety patients in the study were using topical antibiotics, steroids and or antifungal drops at presentation. Gram staining was positive in 9 of the 90 (10 %) eyes cultured. The KOH prep was positive in 28 of the 90 (31.1%) eyes cultured. Eight patients had bacterial growth on the sheep’s blood agar and twenty four had fungal growth on the sabouraud’s agar.
The prevalence of fungal keratitis is extremely high as compared to other epidemiological studies undertaken in other countries. This is probably due to the majority of patients presenting from rural areas (with vegetation trauma) and also due to poor selection of topical antibiotics and misuse steroids prior to presentation at the tertiary eye care centers.
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