Risk factors for pediatric presumed microbial keratitis: A case-control study

Purpose. To evaluate risk factors for pediatric presumed microbial keratiti s and to describe the clinical picture, microbiologic spectrum, treatment m odalities, posttreatment sequelae, and visual outcome in cases of pediatric presumed microbial keratitis. Methods. A case-control study design was use d to identify the risk factors associated with pediatric presumed microbial keratitis. Fifty cases of fresh corneal ulceration aged 12 years or younge r were compared with 50 controls. The study variables included were age, ge nder, immunization status, nutritional status (weight for height), and soci oeconomic status. The clinical presentation of the cases with corneal ulcer ation, microbiologic spectrum, and treatment modalities also were evaluated . All the cases were followed up for a minimum of 3 months, and the posttre atment sequelae and visual outcome were analyzed. Results. The mean (+/- st andard deviation) age of children with corneal ulceration and controls was 4.8 (+/-3.8) years and 5.1 (+/-2.8) years, respectively. Incomplete immuniz ation status (AOR [95% confidence interval (CI)], 1.34 [0.62-2.9]) and poor nutritional status [AOR (95% CI) 1.06 (0.68-1.6)] were not found to be the predictors of corneal ulceration. Lower socioeconomic status was significa ntly associated with the occurrence of corneal ulceration [AOR (95% CI) 1.5 2 (1.1-2.3)]. Corneal trauma (38%) and systemic illness (24%) were the most often associated predisposing factors. Seventy percent of the cases were c ulture positive. Staphylococcus (70%) spe cies was the most frequently isol ated, followed by Pseudomonas aeruginosa (10%). Fungi were isolated in five eyes. Postresolution visual acuity at 3 months could be recorded only in 3 1 eyes and a visual acuity of 6/18 or better was achieved in 22% of these c ases. Conclusion. Corneal ulceration in pediatric age group in India is ass ociated with poverty.