Epidemiologic characteristics, predisposing factors, and etiologic diagnosis of corneal ulceration in Nepal

Corneal ulceration is one of the most frequent causes of blindness in developing countries. Between September 1985 and August 1987, 405 patients with corneal ulceration were examined at Tribhuvan University Teaching Hospital in Kathmandu, Nepal. Males and females were equally affected. The most common predisposing cause of ulceration was corneal trauma, usually with organic agricultural materials. Microorganisms were grown from 324 (80%) of the ulcers. Pure bacterial cultures were obtained from 256 (63.2%) of the patients, whereas pure fungal cultures were obtained from 27 (6.7%) of the patients. In 41 patients (10.1%), corneal cultures yielded a mixed growth of bacteria and fungi. Of a total of 398 bacterial isolates, 124 (31.1%) were positive for Streptococcus pneumoniae, the most commonly isolated organism in the series. Other frequently isolated bacteria included Staphylococcus epidermidis, S. aureus, and Pseudomonas species. Of 68 positive fungal isolates obtained, 32 (47.0%) were identified as Aspergillus species. Candida species and Fusarium species were less commonly seen.