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Br J Ophthalmol 2006;90:968-970 doi:10.1136/bjo.2006.094706
  • Clinical science
    • Scientific reports

Corneal ulceration in South East Asia. II: A strategy for the prevention of fungal keratitis at the village level in Burma

  1. N Maung1,
  2. C C Thant1,
  3. M Srinivasan2,
  4. M P Upadhyay3,
  5. B Priyadarsini2,
  6. R Mahalakshmi2,
  7. J P Whitcher4
  1. 1Trachoma Control and Prevention of Blindness Programme, Department of Health, Yangon, Burma
  2. 2Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar, Madurai 625020, Tamil Nadu, India
  3. 3BP Eye Foundation, GPO Box 2126, Kathmandu, Nepal
  4. 4Francis I Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, CA, USA
  1. Correspondence to: John P Whitcher MD, MPH, Francis I Proctor Foundation, UCSF Box 0944, 95 Kirkham Street, San Francisco, CA 94143-0944, USA; jack.whitcher{at}ucsf.edu
  • Accepted 1 April 2006
  • Published Online First 17 May 2006

Abstract

Aim: To prove that topical antifungal and antibiotic prophylaxis distributed by grass roots village health workers (VHWs) in Burma is an effective public health intervention for the prevention of post-traumatic microbial keratitis in a population where the majority of ulcers are fungal.

Methods: Three villages in Bago District with a combined population of 16 987 were selected for the study. This defined population was followed prospectively for 12 months by 15 VHWs who were trained to identify post-traumatic corneal abrasions with fluorescein dye and a blue torch and to administer 1% chloramphenicol and 1% clotrimazole ointment three times a day for 3 days to the eyes of individuals who fulfilled the eligibility criteria.

Results: During the 12 month period 273 individuals reported to VHWs with an ocular injury and 126 were found to have a corneal abrasion. All 126 were treated with 1% chloramphenicol and 1% clotrimazole ointment three times a day for 3 days, and all healed without sequelae.

Conclusions: Both fungal and bacterial ulcers that occur following traumatic corneal abrasions can be effectively prevented in a village setting by using relatively simple measures that local volunteer public health workers can easily be taught to employ.

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