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Microbial keratitis in children

D Y Kunimoto1, S Sharma, M K Reddy

  • 1Harvard Medical School, Department of Ophthalmology, Boston, Massachusetts, USA.

Ophthalmology
|February 28, 1998
PubMed
Summary
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This study identified key causes of microbial keratitis in children, including trauma and systemic disease. Early recognition and treatment are crucial to prevent vision loss and amblyopia.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Pediatrics

Background:

  • Microbial keratitis is a significant cause of corneal blindness globally, particularly in children.
  • Children are at high risk for irreversible vision deficits, including amblyopia, from infectious keratitis.

Purpose of the Study:

  • To determine the etiologic agents and predisposing factors of childhood infectious keratitis.
  • To evaluate treatment outcomes regarding ocular structure and visual acuity.

Main Methods:

  • Retrospective case series of 113 eyes in 107 children (≤16 years) treated for nonviral microbial keratitis.
  • Inclusion criteria: corneal stromal infiltrate and positive corneal scraping for microbial keratitis.
  • Data collected: etiologic organisms, predisposing factors, treatment, and outcomes (structural and visual acuity).

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Main Results:

  • Principal predisposing factors: trauma (21.2%), ocular disease (17.7%), systemic disease (15.9%), and prior penetrating keratoplasty (8.8%). Vitamin A deficiency was noted in systemic disease cases; contact lens wear was not a factor.
  • Common isolates: Staphylococcus species (43.7%), Streptococcus pneumoniae (18.8%), and fungi (17.2%).
  • 15.9% of eyes required surgery. At follow-up, 36.4% of assessed patients achieved unaided visual acuity of 20/60 or better.

Conclusions:

  • This study is the largest recent analysis of childhood nonviral microbial keratitis, management, and outcomes.
  • Amblyopia is a significant potential sequela of childhood microbial keratitis.
  • Identifying predisposing factors and etiologic agents aids in early recognition and treatment, potentially improving outcomes.