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Abstract:
Forty-seven eyes with microbial keratitis occurring in 44 children under 16 years of age were studied. Under the age of three, 92% of the infections involved Pseudomonas aeruginosa and/or various streptococcal species; later in childhood the typical adult pattern of infection was more common. Overwhelming systemic infections, malignant disease with orbital involvement and congenital ocular adnexal disease were important predisposing factors in the infant years; trauma and acquired external eye disease became increasingly important in mid-childhood. Surgery was necessary in 28% of the eyes. Frequent tearing and lack of patient cooperation preclude reliance on topical antibiotic therapy alone. Despite the difficulties, the mainstay of management involves daily biomicroscopic evaluation and regular subconjunctival antibiotic injections. The logistical problems of achieving these aims are discussed.
Insights
Pediatric microbial keratitis (eye infections) patterns vary by age, with Pseudomonas and Streptococcus common in infants. Management requires intensive monitoring and subconjunctival antibiotics due to challenges with topical treatments.
Area of Science:
- Ophthalmology
- Pediatric Infectious Diseases
Background:
- Microbial keratitis in children presents unique challenges compared to adults.
- Understanding age-specific pathogens and predisposing factors is crucial for effective management.
Purpose of the Study:
- To analyze the clinical characteristics, causative organisms, and management outcomes of microbial keratitis in pediatric patients.
- To identify age-related differences in microbial keratitis patterns and predisposing factors in children.
Main Methods:
- Retrospective study of 47 eyes in 44 children under 16 years with microbial keratitis.
- Analysis of microbial isolates, predisposing factors, treatment strategies, and surgical interventions.
Main Results:
- Infections in children under three were predominantly caused by Pseudomonas aeruginosa and streptococci (92%).
- Predisposing factors shifted from systemic/congenital issues in infants to trauma and external eye disease in older children.
- Surgery was required in 28% of cases; topical therapy alone was insufficient due to patient factors.
Conclusions:
- Microbial keratitis in children exhibits distinct age-specific patterns of pathogens and risk factors.
- Effective management necessitates frequent clinical evaluation and subconjunctival antibiotic injections, acknowledging logistical challenges.