Presumed Microbial Keratitis Cases Resulting in Evisceration and Enucleation in Sydney, Australia

ABSTRACT

Purpose

Describe presumed microbial keratitis cases resulting in evisceration/enucleation from 2012 to 2016 in Sydney, Australia

Methods

A retrospective case review included 33 patients. Cases were identified from pathology and hospital coding data. Sociodemographic and clinical details were collated.

Results

Mean age was 79 years (range: 38–100 years), and 64% female. There were 30 eviscerations and 3 enucleations, at a median time of 8 days (range: 1–270 days) due to endophthalmitis (n = 15, 45%). Major ocular associated factors included topical corticosteroid use in 12 patients (36%), exposure keratopathy in 4 (12%), ectropion in 3 (9%), degenerative corneal disease in 3 (9%), and corneal graft in 2 (6%). Pseudomonas aeruginosa was the most common isolate with no reports of antimicrobial resistance.

Conclusions

Educating elderly patients with a history of topical corticosteroid use, corneal or ocular surface disease about prompt hospital presentation and treatment of microbial keratitis may decrease the probability of losing the eye.

KEYWORDS:

• Corneal scraping
• endophthalmitis
• enucleation
• evisceration
• microbial keratitis

Acknowledgments

The authors acknowledge the clinicians from the corneal unit at the Sydney Eye Hospital who treated the patients diagnosed with microbial keratitis in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Professor Stephanie Watson is supported by the Sydney Medical School Foundation. This study was funded by the Sydney Eye Hospital Foundation.