Infective keratitis in older patients: a 4 year review, 1998-2002.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Geriatric Medicine

Background:

• Infective keratitis in the elderly is underrepresented in clinical literature.
• The elderly population is a significant demographic for keratitis cases.
• Limited data exists on the specific clinical characteristics and outcomes for this age group.

Purpose of the Study:

• To determine the incidence and risk factors of infective keratitis in individuals over 60.
• To identify causative organisms and their antibiotic susceptibilities.
• To evaluate visual and tectonic outcomes and the rate of surgical intervention.

Main Methods:

• Retrospective review of patients aged 60+ diagnosed with infective keratitis.
• Data collected from September 1998 to December 2002 at Sydney Eye Hospital.
• Analysis included risk factors, microbial analysis, and clinical outcomes.

Main Results:

• 190 elderly patients (mean age 75.5) were studied; 93.7% had local and 27.9% systemic risk factors.
• Herpes simplex virus (HSV) PCR was positive in 7.9%, associated with 80% of perforations.
• High rates of surgical intervention (43.7%) and poor visual acuity (6/100 final, excluding LP) were observed.

Conclusions:

• Elderly patients with microbial keratitis form a distinct clinical group with common predisposing factors.
• They experience poor vision, high complication rates, and worse visual outcomes than younger patients.
• HSV is more prevalent in the elderly, increasing severe keratitis risk; bacterial isolates remain largely sensitive to antibiotics.