Demographic Pattern, Risk Factors, Clinical and Microbiological
Characteristics of Fungal KeratitisAshok Kumar Narsani, Partab Rai Nangdev, Sajjad Ali Surhio, Mahesh Kumar,
Shafi Muhammad Jatoi.
PURPOSE: To document the clinico-epidemiological features and laboratory diagnosis of fungal
corneal ulcer observed at a tertiary referral centre.
DESIGN: Prospective descriptive study.
SETTING: Department of Ophthalmology Unit III, Eye Hospital, Liaquat University of Medical and
Health Sciences Hyderabad, Sindh-Pakistan from April 2007 to March 2010.
MATERIAL AND METHODS: Three hundred and fifteen patients of different ages having provisional
diagnosis of suppurative corneal ulceration were registered for the study. Data were collected
through history and slit lamp examination. Corneal scraping was performed. A portion of
each scraping was examined by direct microscopy. Another portion was inoculated directly on
to solid culture media.
RESULT: Among corneal scraping from 315 patients, the fungus grew in 116 (36.8%). The mean
age of patients was 42.6 years (ranged between 9 and 82 years). Majority of patients (80;
68.97%) were between the 3rd and 5th decade of life. Males (72; 62.1%) were affected more often.
Majority of the patients (80; 69%) was from rural areas. A majority of (52; 44.80%) patients was
farmer by profession. Corneal trauma (70; 60.4%) was identified as the leading precipitating factor.
Forty eight (41.4%) patients had corneal injury with vegetative material. The peak incidence
observed in the months of October to December followed by March to June. The clinical features
were dry, thick and raised grayish white corneal surface in 76 (65.51%) patients, stromal
infiltrates with feathery margins in 64 (55.2%) patients, typical satellite lesions in 19 (16.38%)
patients, hypopyon was present in 70 (60.3%) patients. Candida albicans was the most frequent
organism which was isolated in eighty (69%) patients.
CONCLUSION: Fungi were found to be the frequent cause of suppurative corneal ulcer following
agriculture trauma and Candida albicans being the most commonly isolated pathogen. For
the diagnosis of fungal infection direct microscopic examination with potassium hydroxide 10%
is a rapid, inexpensive, and reliable method.
Fungal keratitis, vegetative trauma, potassium hydroxide, Candida albicans,