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Risk factors for pediatric presumed microbial keratitis: a case-control study
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. rbvajpay@medinst.ernet.in
Purpose:
To evaluate risk factors for pediatric presumed microbial keratitis and to describe the clinical picture, microbiologic spectrum, treatment modalities, posttreatment sequelae, and visual outcome in cases of pediatric presumed microbial keratitis.
Methods:
A case-control study design was used to identify the risk factors associated with pediatric presumed microbial keratitis. Fifty cases of fresh corneal ulceration aged 12 years or younger were compared with 50 controls. The study variables included were age, gender, immunization status, nutritional status (weight for height), and socioeconomic status. The clinical presentation of the cases with corneal ulceration, microbiologic spectrum, and treatment modalities also were evaluated. All the cases were followed up for a minimum of 3 months, and the posttreatment sequelae and visual outcome were analyzed.
Results:
The mean (+/- standard deviation) age of children with corneal ulceration and controls was 4.8 (+/-3.8) years and 5.1 (+/-2.8) years, respectively. Incomplete immunization status (AOR [95% confidence interval (CI)], 1.34 [0.62-2.9]) and poor nutritional status [AOR (95% CI) 1.06 (0.68-1.6)] were not found to be the predictors of corneal ulceration. Lower socioeconomic status was significantly associated with the occurrence of corneal ulceration [AOR (95% CI) 1.52 (1.1-2.3)]. Corneal trauma (38%) and systemic illness (24%) were the most often associated predisposing factors. Seventy percent of the cases were culture positive. Staphylococcus (70%) species was the most frequently isolated, followed by Pseudomonas aeruginosa (10%). Fungi were isolated in five eyes. Postresolution visual acuity at 3 months could be recorded only in 31 eyes and a visual acuity of 6/18 or better was achieved in 22% of these cases.
Conclusion:
Corneal ulceration in pediatric age group in India is associated with poverty.
Insights
Pediatric microbial keratitis in India is linked to poverty, with corneal trauma and systemic illness as common causes. Staphylococcus species were the most frequent bacterial isolates.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Microbial keratitis is a significant cause of corneal opacity and vision loss in children.
- Understanding risk factors and clinical characteristics is crucial for effective management of pediatric microbial keratitis.
Purpose of the Study:
- To identify risk factors for pediatric presumed microbial keratitis.
- To describe the clinical presentation, microbiology, treatment, and outcomes of pediatric microbial keratitis.
Main Methods:
- A case-control study compared 50 children (≤12 years) with corneal ulceration to 50 controls.
- Evaluated risk factors including immunization, nutrition, and socioeconomic status.
- Clinical data, microbiology, treatment, and 3-month visual outcomes were analyzed.
Main Results:
- Lower socioeconomic status was significantly associated with corneal ulceration.
- Corneal trauma (38%) and systemic illness (24%) were primary predisposing factors.
- Staphylococcus species (70%) were the most common isolates; 22% achieved 6/18 or better vision at 3 months.
Conclusions:
- Pediatric corneal ulceration in India is associated with poverty.
- Early diagnosis and treatment are essential to improve visual outcomes in affected children.