• Dr. Md. Arfan Ullah Raihan

Corneal opacification has become the second most common cause of visual disability in the world.’ Suppurative keratitis is an important preventable cause of blindness in the developing world. Most of the organisms cultured from corneal infections are of the same species that are normally present on the lids and periocular skin, in the conjunctival sac or in adjacent nasal passage. However, both gram-positive and gram-negative bacteria are responsible for causing suppurative corneal ulcers with Staphylococcus, Streptococcus and Pseudomonas are the most frequent isolates. While among the fungal causes of suppurative corneal ulcers, Fusarium and Aspergillus species are the predominant agents reported by many investigators. In Bangladesh corneal ulcer is also a problem for many patients. However the present study has conducted to explore the suppurative corneal ulceration in Bangladesh and to provide policy recommendations. The study was conducted at inpatients and outpatients at the Chittagong Eye Infirmary with the diagnosis of suppurative keratitis were studied. The study was descriptive cross sectional study. Purposive sampling method was used for the study. Data were collected from primary and secondary sources. Primary data were collected from the patients of the selected study area. Secondary data were collected from secondary sources. Patients of eye hospital of Chittangong are the sample population of the study. Total 142 patients were selected for the study. Patient information, clinical histories and clinical features of infection were recorded at presentation and updated during treatment. Representative areas of suppuration in the cornea were sampled using a sterile ‘Kimura’ platinum spatula or a scalpel blade. A local anaesthetic without preservative was used. Smears were fixed with 95% methanol before Gram staining by standard methods. The culture, identification and antibiotic sensitivity methods used were those described previously. Facilities for anaerobic, mycobacterial and acanthamoeba culture were not available. Some bacteria and all fungi were sent for identification and antifungal sensitivity testing was performed at eye hospitals in Chittagong city in Bangladesh. Questionnaire was used for data collection. Data were collected by observing the patients and face to face interview with the patients. Collected data were analyzed by using Computer Program Microsoft EXCEL. From the result it was found that suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. The five most common pathogens were: Pseudornonas sp. 24%, Streptococcus pneumoniae 7%, Aspergillus sp. 13%, Fusariurn sp. 7% and Curvularia sp. 6%. Gram stain and culture results were consistent in 62.6% of cases. Previous antibiotic treatment was a significant factor for failure of culture isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were missed. Over all, Gram stain had a sensitivity of 62% and positive predictive value of 84% for bacterial cases, and 98% and 94% for fungal cases, respectively. Fungal ulcers were typically filamentous, but an antecedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusariurn cases were seen only in the hot, dry season.

Corneal ulcer, Scarring, Microbial cause, Gram stain, Trauma, Intractable infection

"A Study on Corneal Ulceration in Bangladesh", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.10, Issue 8, page no.f47-f55, August-2023, Available :http://www.jetir.org/papers/JETIR2308509.pdf

"A Study on Corneal Ulceration in Bangladesh", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.10, Issue 8, page no. ppf47-f55, August-2023, Available at : http://www.jetir.org/papers/JETIR2308509.pdf