Epidemiologic Characteristics, Predisposing Factors and Microbiological Profile of Infectious corneal ulcers: The Portsmouth Corneal Ulcer Study.

Abstract

Aim: To identify the incidence, predisposing factors, clinical and microbiological diagnosis of infectious corneal ulcers in a population based in southern England.

Methods: A retrospective review of the medical records of patients presenting with infectious corneal ulcers at the eye casualty department of Queen Alexandra Hospital, Portsmouth between January 1997 and December 2003.

Results: A total of 1,786 patients presented with infectious corneal ulcers with a mean age of 45 years and female predominance (54.5%). Contact lens wear (CLW) was the main predisposing factor in 554 patients (31%). Corneal scrapes from 1,254 patients grew positive cultures in 800 patients. Gram-positive bacteria accounted for 696(71.1%)of the total 979 bacterial isolates, while Gram-negative bacteria accounted for 283(28.9%) with the predominance of Pseudomonas aeruginosa. Nine out of 11 patients with Acanthamoeba keratitis were contact lens wearers (CLWs). The majority of patients 1,728 (96.8%) sought medical help more than once and 34 patients (1.9%) had poor visual outcome. Follow-up was completed in 1633 patients (91.4%) with an average of 11.5 days.

Conclusions: Contact lenses remain the most important risk factor for infectious corneal ulcers. Reduction of the rate and severity of infectious keratitis requires continuous education of patients, and professionals.