A thirteen-year tertiary centre experience with infectious keratitis in the elderly population

Area of Science:

• Ophthalmology
• Infectious Diseases
• Geriatrics

Background:

• Infectious keratitis poses a significant threat to vision, particularly in elderly populations.
• Understanding the specific pathogens and risk factors in this demographic is crucial for effective management.

Purpose of the Study:

• To classify, describe clinical presentation, and evaluate treatment outcomes for infectious keratitis in patients aged 60 years and older.
• To identify common pathogens and associated comorbidities influencing outcomes in elderly infectious keratitis cases.

Main Methods:

• A retrospective single-center analysis of 317 patients (≥60 years) diagnosed with infectious keratitis between January 2012 and January 2025.
• Evaluation of microbiological cultures, clinical course, comorbidities, treatments, and visual acuity outcomes.

Main Results:

• Streptococcus pneumoniae was the most frequent pathogen (29.7%), contrasting with other reports.
• Mean best-corrected visual acuity improved significantly post-treatment (p < 0.001).
• Dry eye (43.8%) and systemic immunosuppression (36.9%) were prevalent comorbidities associated with poorer outcomes; recurrence and need for corneal transplantation or evisceration were noted.

Conclusions:

• Elderly infectious keratitis may be predominantly caused by Streptococcus pneumoniae, suggesting regional variations.
• Dry eye and systemic immunosuppression are significant risk factors for adverse outcomes in this population.
• Personalized treatment strategies addressing these comorbidities are essential for improving visual outcomes.