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ORIGINAL ARTICLE
Year : 2011  |  Volume : 59  |  Issue : 5  |  Page : 367-371

Mycotic corneal ulcers in upper Assam


1 Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, India
2 Department of Ophthalmology, Assam Medical College and Hospital, Dibrugarh, India
3 Regional Medical Research Centre, Dibrugarh, India

Correspondence Address:
Reema Nath
Department of Microbiology, Assam Medical College, Dibrugarh-786 002, Assam
India
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Source of Support: Indian Council of Medical Research, New Delhi for financial grant, Conflict of Interest: None


DOI: 10.4103/0301-4738.83613

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Purpose : To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. Materials and Methods: In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. Results: In 188 (60.6%) cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%). The maximum (23.4%) cases were reported during the paddy harvesting season in Assam (January and February). Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH) mount. The commonest predisposing factor was corneal injury (74.5%). While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25%) was the commonest isolate followed by Aspergillus species (19%), Curvularia species (18.5%) and Penicillium species (15.2%). Yeasts were isolated in 2.7% (n=5) cases. Conclusions : Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.


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