A study of Mycotic keratitis in a tertiary care hospital in North-East Karnataka

Introduction: Fungal keratitis is a major blinding eye disease in Asia, has been known since 1879, when Leber reported first case. The acuteness of problem in Northeast Karnataka area is due to hot and dry environment with agriculture as major occupation. Objectives: To study the prevalence of fungi causing keratitis and to identify the causative agents. Material & Methods: A total of 130 non-repetitive corneal scrapings collected during a period of 1 year were included in the study. All the corneal scrapings samples were subjected to Gram’s staining to see for the presence of bacteria, yeasts and other fungi, examined in 10% KOH mount. The scrapings were also inoculated on SDA slants with antibiotics and with or without cycloheximide and incubated at room temperature & at 370 C, respectively. Slants were observed for fungal growth daily for upto 3 weeks. The identification of the fungal growth was done on the basis of cultural characteristics and microscopic morphology on LPCB staining. Results: Out of 130 samples, 50 samples were found positive for fungal culture. Among 50, 46 were positive for fungi in KOH mount microscopy and 4 were negative.  Of the 50 fungal cultures, 26 were Aspergillus spp, 10-Fusarium, 8-Penicillum & 6-Candida. Among the samples positive for fungal growth, 74% were from patients of 21-40 yrs of age group. Males are affected more common than females. The major predisposing factors here are trauma (76%), cataract surgery (8%), diabetes mellitus (6%) and use of contact lens (4%). Conclusion: Mycotic keratitis should be suspected in patients with a corneal lesion and must be ruled out before commencing steroids or antibiotics in order to save the sight. The findings of the study suggests that 21-40 yrs age group are more prone for  mycotic keratitis and also it is more commonly seen in males in this region. History of trauma is the major predisposing factor observed. Fungal Culture is more sensitive than KOH mount method for diagnosis. In p