Non-viral microbial keratitis: etiology, clinical features and visual outcome

To determine the etiology, clinical features and visual outcome in non-viral microbial keratitis.

An observational study (case series).

Department of Ophthalmology, Khyber Teaching Hospital, Peshawar, Pakistan, from January 2007 to December 2009.

Charts of all patients with infective keratitis treated at the department were reviewed. The data collected and recorded on a standardized form included age, gender, predisposing factors, microbiology results of culture and sensitivity, clinical features, treatment given, complications and visual acuity at last follow-up (at least 2 months).

Among a total of 228 cases, 148 were male (64.9%) and 80 were female (35.1%). Mean age of the patients was 42.8 ± 21.9 years. Trauma was the most common (31.5%) predisposing factor followed by previous ocular surgery (8.8%) and use of topical steroids (6.6%). The most common isolate among positive cultures was Staphylococcus aureus isolated in 31.4% (11/35) eyes followed by fungal hyphae in 25.7% (9/35) and Gram negative bacilli in 17.1% (6/35) eyes. Visual outcome was good (> 6/18) in 19.6 %, moderate (< 6/18 to ³ 6/60) in 22% and poor (< 6/60) in 58.4%.

The main predisposing factors in the studied group of patients with non-viral keratitis were ocular trauma and injudicious use of topical steroids. The most common microorganism involved was Staphylococcus aureus. Visual outcome was moderate to poor even after successful treatment.