Suppurative Corneal Ulcers at a Tertiary Hospital Southeast Nigeria: A 5-Year Review

Abstract

Background: Suppurative corneal ulcer is a potentially blinding condition. Objectives: To determine the changes in demographic factors, microbial flora, and antimicrobial sensitivity of suppurative corneal ulcers. Materials and Methods: These were retrieved from the case files and microbiological laboratory register of patients in whom the diagnosis of the suppurative corneal ulcer was made from 2015 to 2019: age, sex, laterality, occupation, place of abode, the month of presentation, causative factor, duration of symptoms and use of medications prior to presentation, Gram stain, culture isolate and sensitivity result. Result: Of the 753 records reviewed there were more males (54%) affected than females (46%); the mean age was 42.6 years. The commonest predisposing factor was physical trauma (41.34%). The peaks of infections were in March and August while the least occurred in May and December. Dependents (181) and traders (153) were more likely to have used eye medications before the presentation. Though there was no statistical significance between visual acuity and the duration of infection prior to presentation, most patients who presented within 5 days of onset had better visual acuity ( 6/6 to 6/18). There was a statistical significance between the duration of drug usage before the presentation and visual acuity (p = 0.0043). The commonest organisms were staphylococcus aureus and Aspergillus spp. The highest bacterial sensitivities were to fluoroquinolones, cefuroxime, and amoxicillin/clavulanic acid. Conclusion: All corneal ulcers must be managed promptly and supported by adequate laboratory services. Measures must begin with preventive strategies aimed at curtailing their occurrence through the primary health care program.