Mycotic flora of trachomatous conjunctiva

HV Nema; JS Mathur; V Thakur

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Year : 1976 | Volume : 24 | Issue : 2 | Page : 9-11

Mycotic flora of trachomatous conjunctiva

HV Nema, JS Mathur, V Thakur
Institute of Medical Sciences, Banaras Hindu University, Varanas, India

Correspondence Address:
H V Nema
Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005
India

Source of Support: None, Conflict of Interest: None

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How to cite this article:
Nema H V, Mathur J S, Thakur V. Mycotic flora of trachomatous conjunctiva. Indian J Ophthalmol 1976;24:9-11

How to cite this URL:
Nema H V, Mathur J S, Thakur V. Mycotic flora of trachomatous conjunctiva. Indian J Ophthalmol [serial online] 1976 [cited 2021 Apr 19];24:9-11. Available from: https://www.ijo.in/text.asp?1976/24/2/9/31525

Table 2

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Table 1

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Bacterial flora of the normal conjunctiva has been extensively studied[1],[5],[8],[12],[13],[14] A few reports, however, appeared on the fungal flora of the conjunctiva [3],[6],[7],[11],[16] It has been suggested that the use of antibiotics and corticosteroids in recent years has significantly increased the incidence of mycotic infections of the eye[2],[4],[9],[15]. The studies of mycotic flora of the conjunctiva assume great importance in a country like India where trachoma is endemic in certain areas and use of broad spectrum antibiotics is quite frequent.

It was therefore, thought proper to investigate the mycotic flora of the trachomatous conjunctiva.

Material and Methods

206 cases of trachoma attending the out-patient department of Bhuwalka Eye Hospital, Banaras Hindu University, Varanasi, were selected for the study. Ninety-eight cases had active trachoma (Tr. I, II, and III) and 108 cases had healed trachoma (Tr. IV). The criteria of the diagnosis and classification adopted in the present study were same as recommended by the WHO Expert Committee on Trachoma[17]. Practically all the cases had had treatment (topical antibiotics and oral sulphonamides) for the disease. Cultures for fungus were taken from the lower fornix and seeded on Sabouraud's dextrose-agar slants (pH 6.0). Wet films from the scrapings were also made with a drop of KOH and examined under microscope for the presence of fungi. The inoculated tubes were kept at room temperature and examined daily. All positive cultures were allowed to grow so as to be finally identified by their colony characteristics and morphology, under lactophenol-cotton blue preparation.

In order to rule out the possibility of laboratory contaminations, 20 sterile swabs were exposed to air for 2 minutes and stroked on the Sabouraud's slants. The culture was considered negative if no growth was seen 2 weeks after the inoculation.

Results

Out of a total of 206 cultures from the trachomatous conjunctiva, 51 (24.76 per cent) were positive for fungus. However, only 7 (3.39 per cent) smears were positive on direct microscopic examination [Table - 1]. Most of the fungi isolated were saprophytic in nature [Table - 2]. The fungal flora in cases with active trachoma (25.92 per cent) did not differ significantly from that of the healed trachoma (23.47 per cent). All the 20 cultures done for testing the laboratory contamination were found to be sterile.

Discussion

The role of the secondary bacterial infection on the course of trachoma is well known. However, there is a complete lack of information on the possible effect of fungal contamination on trachoma[10]. The present investigation reveals that 24.76 per cent of the cases of trachoma do harbour various types of fungi in their conjunctival cul de sac. Majority of these fungi are saprophytes, generally grouped under contaminants or opportunistic fungi. The most common mould isolated in the present study is Aspergillus (8.25 per cent), followed by Alternaria (4.85 per cent) and Hormodendrum (4.37 per cent). The prevalence of the fungi in the trichomatous conjunctiva found in the present study does not differ significantly from that of the normal conjunctiva (22.2 per cent reported in an earlier study by Nema et al)[11].

Fazakas[6] suggested that the incidence of fungus isolation seems to rise in diseased eye. This point has been tested by analysing the percentage of the positive cultures between the active and healed trachoma groups, which however, showed an insignificant difference in the present series (p.>0.1).

A few pathogenic strains of Aspergillus and Candida were isolated from the trachoma cases but none of these cases showed any specific ocular manifestation.

Summary

Fungal culture studies were carried out in 206 cases of trachoma. Fifty-one cases (24.76 per cent) were found to be positive. The common fungi isolated were Aspergillus, Alternaria and Hormodendrum. There was no significant difference between the mycotic flora of the active and healed trachomatous cases.

Acknowledgement

Authors are thankful to Dr. M. S. Dwivedi, Reader in Mycology, Faculty of Science, B.H.U., for his help during the work.

The technical assistance provided by Mr. B. N. Anugrahit and Mr. A. M. Verma is thankfully acknowledged.

References

1.	Agarwal, L. P. and Khosla, P. K., 1963, Orient. Arch. Ophth., 1, 145.
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10.	Nataf, R., 1969, Personal Communication to H. V. Nema.
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13.	Saudako.T, P. F., 1954, Amer. J. Ophth., 38, 374.
14.	Smith, C. H., 1964, Brit. J. Ophth., 38, 719.
15.	Torak, R. M., 1957, Amer. J. Med., 22, 872.
16.	Williamson, J., Gordon, A. M., Wood, R., McKdyer, A., and Yahya, O. A., 1968, Brit. J. Ophth., 52, 127.
17.	WHO Expert Committee on Trachoma, 1953, II Report, W.H.O., Geneva, pp. 67.