Non-viral microbial keratitis: etiology, clinical features and visual outcome.

Objective: To determine the etiology, clinical features and visual outcome in non-viral microbial keratitis.

Study Design: An observational study (case series).

Place And Duration Of Study: Department of Ophthalmology, Khyber Teaching Hospital, Peshawar, Pakistan, from January 2007 to December 2009.

Methodology: Charts of all patients with infective keratitis treated at the department were reviewed. The data collected and recorded on a standardized form included age, gender, predisposing factors, microbiology results of culture and sensitivity, clinical features, treatment given, complications and visual acuity at last follow-up (at least 2 months).

Results: Among a total of 228 cases, 148 were male (64.9%) and 80 were female (35.1%). Mean age of the patients was 42.8 ± 21.9 years. Trauma was the most common (31.5%) predisposing factor followed by previous ocular surgery (8.8%) and use of topical steroids (6.6%). The most common isolate among positive cultures was Staphylococcus aureus isolated in 31.4% (11/35) eyes followed by fungal hyphae in 25.7% (9/35) and Gram negative bacilli in 17.1% (6/35) eyes. Visual outcome was good (> 6/18) in 19.6 %, moderate (< 6/18 to ³ 6/60) in 22% and poor (< 6/60) in 58.4%.

Conclusion: The main predisposing factors in the studied group of patients with non-viral keratitis were ocular trauma and injudicious use of topical steroids. The most common microorganism involved was Staphylococcus aureus. Visual outcome was moderate to poor even after successful treatment.