Diagnosis, clinical features and treatment outcome of microsporidial keratoconjunctivitis

Aim To report the clinical and microbiological profile of patients with microsporidial keratoconjunctivitis in a tertiary eye care centre in India.

Methods A retrospective analysis of medical records of all cases of microbiologically confirmed microsporidial keratoconjunctivitis, who presented between March 2007 and October 2010, was done. In a single-centre, institutional setting, 278 eyes of 277 apparently healthy patients were analysed.

Results The mean age was 36±14 years (range 6–80). The mean duration of symptoms was 7.7±6.2 days (range 1–60). Keratic precipitates were present in 20.1% patients. A superficial scar was present in 39.2% patients. Majority (26.6%) of the patients reported in the month of August. Microscopic examination of corneal scraping, using potassium hydroxide with calcofluor white and Gram stain, demonstrated microsporidial spores in 98.9% and 89.7% cases, respectively. Patients received either topical 0.02% polyhexamethylene biguanide or lubricants. The mean time for resolution was 6.0±2.9 days (range 2–18). Final visual acuity was ≥20/30 in 75.1% cases.

Conclusions Microsporidial keratoconjunctivitis is common in India. It is seasonal, can occur in healthy individuals and can be diagnosed using simple microbiological methods. Treatment outcome is generally satisfactory.