Epidemiology of Infectious Corneal Ulcers at Tertiary Centers in Vancouver, BC
To study the epidemiology of cultured infectious corneal ulcers in Vancouver, BC, Canada.
This is a multicentre, retrospective, observational case series and chart review of 264 infectious corneal ulcers. Predetermined search terms were entered into the hospitals’ electronic microbiol-ogy databases to create a cohort of patients that had undergone corneal scrapings for ulcers from January 2007 to April 2011. All specimens were plated on culture media. Cultured species were identified, and antimicrobial sensitivities were performed. Clinical charts were then reviewed to identify associated risk factors and management. Treatment outcomes, as defined by response to medical therapy and need for surgical management, were assessed.
Positive culture results were most commonly Gram-positive bacteria, followed by Gram-negative bacteria, then fungi, and finally parasites. Potential risk factors included: contact lens wear; poorly controlled underlying ocular surface disease, namely blepharokeratoconjunctivitis; trauma with subsequent recurrent corneal erosion syndrome; prior ocular surgery; and immunocompromised status. A total of 51 eyes underwent surgical management for either therapeutic or symptomatic reasons.
Infectious corneal ulcers continue to be an important cause of morbidity and visual loss in a large Canadian city, with 19.32% requiring surgical intervention. It is imperative to appreciate common risk factors in order to effectively counsel patients, triage referrals, and create appropriate follow-up plans for acute ulcers.