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KOH mount as an aid in the management of infectious keratitis at secondary eye care centre
  1. Varsha M Rathi1,2,
  2. Monica Thakur2,
  3. Savitri Sharma3,
  4. Rohit Khanna2,
  5. Prashant Garg1
  1. 1Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
  2. 2GPR-ICARE, L V Prasad Eye Institute, Hyderabad, India
  3. 3Jhaveri Microbiology laboratory, L V Prasad Eye Institute, Hyderabad, India
  1. Correspondence to Dr Varsha M Rathi, Tej Kohli Cornea Institute,Gullapalli Pratibha Rao International Center for Advancement of Rural Eye Care (GPICARE), L V Prasad Marg, Banjara Hills, Hyderabad-500034, TS, India; varsharathi{at}lvpei.org, varsharathi2020{at}gmail.com

Abstract

Aims To report the clinical outcome of infectious keratitis managed after doing 10% KOH mount of corneal smears and reporting done by an ophthalmologist in the secondary eye care centre in South India.

Methods 103 consecutive cases of microbial keratitis were studied. Inclusion criteria were presence of corneal infiltrate on slit lamp biomicroscopy. An ophthalmologist carried out microbiological evaluation of 10% KOH mount of corneal scrapings. No cultures were done at secondary centres. Antifungal therapy with 5% Natamycin was initiated when 10% KOH mount was positive for fungal filaments. Else, the patients were started on combined topical ciprofloxacin (0.3%) and fortified cefazolin (5%).

Results 41/103 (39.8%) smears were positive for fungus and 62 (60.2%) were negative. 89 out of 103 patients (86.40%) healed with scarring at an average of 2.95±1.58 weeks. Healing was noted in 39/41 (95.12%) of patients at an average of 3.06±1.19 weeks in patients with KOH smear positive keratitis. 80.64% (50/62) healed with scarring at an average period of 2.86±1.86 weeks in KOH mount negative keratitis.

Conclusions Initial smear examination of KOH mount by an ophthalmologist helped in diagnosis of infectious keratitis caused by fungi and its management and 95.12% of KOH positive patients healed with scarring. Reading of KOH mount by an ophthalmologist helped in initiation of specific therapy with improved clinical outcome.

  • Infection
  • Cornea

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Footnotes

  • Contributors All authors have contributed to the manuscript.

  • Funding Hyderabad Eye Research Foundation

  • Competing interests None declared.

  • Ethics approval IRB, LV Prasad Eye Institute, Hyderabad, India.

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