Suppurative Keratitis in a Nigerian Tertiary Hospital

Abstract

Purpose: Microbial keratitis is a potentially vision threatening condition that requires prompt diagnosis and treatment to prevent untoward outcome. This study describes the demographic characteristics, clinical presentation, and microbiological features of patients diagnosed with suppurative keratitis between April 2005 and May 2006 in the University College Hospital lbadan, Nigeria. Methods: A retrospective review of case notes of patients who presented with suppurative keratitis between April 2005 and May 2006 was done. The outcome measures were: interval between onset and presentation, aetiology of keratitis, extent of corneal involvement and final visual acuity. Results: There were 23 (65.7%) males and 12 (34.3%) females. The mean age was 32.8±18.64. A positive history of trauma was present in 48% of patients. In 6% of the patients, the predisposing factor was severe allergic conjunctivitis. The presenting visual acuity was <6/60 in 66% of the patients, <6/18—6/60 in 14%, and 6/6-6/18 in 17% of the patients. At discharge, 40% had a visual acuity of 6/6-6/18, 15% had borderline vision (<6/18-6/60), 40% had severe visual impairment (<6/60), while 5% had no light perception. The most common organisms isolated microbiologically were Staphylococcus aureus in 28.6%, Streptococus pneumoniae in 8.6%, and Pseudomonas aeruginosa in 2.9%. The risk factors for poor visual outcome were late presentation, farming, stromal thinning and large corneal involvement. Conclusion: Bacteria is responsible for most cases of suppurative keratitis in a developing country like Nigeria and the risk for poor visual outcome includes late presentation, farming, stromal thinning and large corneal involvement.

Key words: cornea, suppurative keratitis, visual outcome