Microbial keratitis in children-A descriptive study

Aim: The purpose of this study is to determine predisposing risk factors, microbiological profile and visual and structural treatment outcome of non viral microbial keratitis in children. Materials and Methods: A prospective case study of 52 eyes with microbial keratitis in a tertiary care teaching institute over a period of two years in children <16 years of age. Data was analyzed for patient demographics, culture data, management trends and visual and structural outcome of treatment. Results: Mean age of patients was 8.22 years ranging from 7 days to 14 years. The most common predisposing risk factor was trauma (57.69%), followed by malnutrition/Vitamin A deficiency (7.69%) unidentified causes accounted for 30.76% of cases. Cultures were taken from all patients. A total of 55.76% of eyes were culture positive.Bacterial isolates were seen in 30.76% of eyes, followed by fungi in 25% of the culture positive isolates. No growth in 44.23% of patients. Gram positive cocci(predominantly Staphylococcus aureus) were seen in 11.53% of isolates, and gram negative bacilli (predominantly Pseudomonas aerugionosa) in 19.23%. Fungi were identified in 25% of culture positive eyes with equal number of Aspergillus and Fusarium sp. Monotherapy with broad spectrum antibiotics was the preferred treatment. Final visual acuity on last follow up was < 6/60 in 20 eyes (62.5%) One patient each required therapeutic keratoplasty, conjunctival hooding and cyanoacrylate glue with bandage contact lens. Conclusion: Trauma was the predominant risk factor for microbial keratitis with Pseudomonas aeruginosa being the most common microorganism isolated. Majority of the cases responded to medical management.