Management of infective corneal ulcers in a high-income developing country

Microbial keratitis is a major risk for corneal blindness worldwide. We aimed to study the clinical presentation and outcome of hospitalized patients having infective corneal ulcers. All patients who were diagnosed as microbial keratitis and were admitted to Al-Ain Hospital during the period July 2011-Dec 2016 were retrospectively studied. Patients’ demography, predisposing factors, symptoms and signs at presentation, time to presentation after onset of symptoms, microbial isolates, hospital stay, and visual acuity (VA) outcome were studied. 74 patients with corneal ulcers were hospitalized. 79.7% were males. The median (range) age was 44 years (1–91). 36.5% had trauma as a risk factor. The main presenting symptoms were pain (90.5%), red eye (79.7%), and decreased vision (63.5%). All patients had stromal infiltrate while 39.2% had hypopyon at presentation. The average time from the start of the symptoms to hospital presentation was 11 (1–90) days. The mean (range) hospital stay was 10.6 (1–60) days. Forty eyes were culture positive. Bacteria were identified in 27 eyes and fungus in 16. Pseudomonas aeruginosa (9 eyes) and Staphylococcus epidermis (5 eyes) were the most common bacterial islolates. Aspergillus (6 eyes) was the most common fungus species. 95.2% of the bacterial isolates were susceptible to the quinolone antibiotics group. Twenty eight (51.9%) patients had a vision worse than 6/60 in the affected eye. Corneal ulcer poses a significant threat to the sight of an affected eye. Trauma was the most common risk factor for corneal ulcers. Usage of eyes personal protective equipment for high risk occupations and earlier accessibility to health care may reduce the impact of corneal ulcers in our community.