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Clinical science
Microbiological and clinical profiles of patients with microbial keratitis residing in nursing homes
  1. V Jhanji,
  2. M Constantinou,
  3. H R Taylor,
  4. R B Vajpayee
  1. Centre for Eye Research Australia, University of Melbourne, Australia
  1. Correspondence to Dr R B Vajpayee, FRANZCO, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne, Victoria 3002, Australia; rasikv{at}unimelb.edu.au

Abstract

Aim: To study the microbiological and clinical profile of patients with microbial keratitis living in nursing homes.

Methods: A retrospective analysis of hospital records from 1996 to 2006 of patients who had microbial keratitis, and were living in nursing homes, was undertaken. The main parameters evaluated were clinical and microbiological profile and final visual outcome.

Results: Of 66 patients included in this study, 39 were female and 27 were male, with mean age of 81(SD 11) (range 46–97) years. The major ocular and systemic factors associated with the occurrence of microbial keratitis were the presence of dry eyes (26%) and rheumatoid arthritis (81%), respectively. A positive bacterial culture was obtained in 54 (82%) cases with Staphylococcus being the most prevalent isolate (48%). Seven patients had positive culture for herpes virus. Surgical intervention had to be performed in 31(47%) of cases mainly in the form of botox injection for induction of ptosis (n = 9, 27%), keratoplasty (n = 8, 24%), tarsorrhaphy (n = 5, 15%) or glue (n = 3, 9%). The mean pre-treatment and post-treatment visual acuity was counting fingers and 6/60 respectively.

Conclusions: Microbial keratitis in patients living in nursing homes is usually caused by Staphylococcus and is associated with dry eyes and ocular surface disease. Surgical intervention is required in majority of cases with poor visual outcome.

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Footnotes

  • Presented in part at the annual ARVO 2008 meeting.

  • Funding None

  • Competing interests None

  • Ethics approval The study was approved by the Human Research Ethics Committee of the hospital and adhered to the tenets of the Declaration of Helsinki.

  • Patient consent Obtained

  • Provenance and peer review Not commissioned; externally peer reviewed.