Pattern of presentation and microbial isolates of corneal ulcers at Alex Ekwueme Federal University Teaching Hospital Abakaliki

Abstract

Background: Corneal ulceration is sight-threatening. Accurate determination of the pattern, causative organisms and  factors affecting severity and outcome will guide management.

Objectives: To determine the pattern and microbiological diagnosis of corneal ulcers seen at Alex Ekwueme Federal  University Teaching Hospital Abakaliki (AEFUTHA).

Materials and Methods: This was a longitudinal descriptive study of all consenting consecutive corneal ulcer patients  managed at AEFUTHA from December 2018 to December 2019. Socio-demographic data, relevant history, clinical and  laboratory findings were documented. Data was analysed using Statistical Package for Social Sciences (SPSS) version 22. 

Findings: There were 18 corneal ulcer patients among the 3853 consecutive new patients seen within the study period  (a hospital prevalence rate of 0.47%). All 18 patients were recruited. They were aged 23 to 84 years; mean age was 50.4 ±  15.7. Majority were females 11(61.1%); 50% were farmers; 50% had preceding eye injury; 94% practiced prior self- medication; 72.2% presented ≥ 2 weeks after onset of symptoms. The ulcers were mostly central (61.1%); wide (>5 mm)  77.8% and deep (posterior stromal) 77.8%. Microorganisms isolated from 11(61.1%) specimens were: bacteria 6 (54.5%);  fungi 4 (36.4%); acanthamoeba 1 (9.1%). Bacterial isolates were: staphylococcus aureus (5.6%) and pseudomonas aeruginosa (5.6%).

Conclusion: Corneal ulcers presenting at AEFUTHA were severe (centrallylocated, wide and deep)  with poor visual outcome after treatment. The microbial isolates were bacteria, fungi and acanthamoeba. Late  presentation after prior self-medication was common. Public education on early hospital presentation is necessary.  Corneal transplant services are also needed for visual rehabilitation.