Corneal ulcers at a Nigerian eye hospital

Objectives: To determine the incidence, pattern, predisposing factors and treatment outcome of corneal ulcers at the Guinness Eye Center Onitsha, Nigeria. Methods: A retrospective study of corneal ulcer patients treated between July 1998 and June 2000. Results: One hundred and twenty eyes of 117 patients (1.2% of new patients) were treated. Farmers, pensioners and housewives presented late to hospital compared to students, preschool children, traders, artisans and civil servants (p < 0.001). 66 eyes (55%) had peripheral ulcers; 45% were central ulcers. Central ulcer patients presented late to hospital (p < 0.01; OR – 3.0; CI: 1.29, 6.97) and also had worse visual acuity (p < 0.001; OR – 8.8; CI: 3.3, 22.9). 89 eyes were culture-negative. Organisms identified in other specimens were fungi (14 eyes); herpes simplex keratitis (9 eyes) staphylococcus aureus (3 eyes); streptococcus pneumonia in (2 eyes); coliforms (2 eyes); mixed infection with staphylococcus aureus and coliforms (1 eye). Major predisposing factors were trauma (54.8%); traditional eye medicines (23.1%) and self-medication with corticosteroids (10.5%). Post-treatment, 44 eyes (36.7%) gained 1-7 lines of visual acuity and blindness was reduced by 40.5% (p < 0.01; OR – 2.3; CI: 1.33, 3.99). Complications included leucoma (18 eyes); corneal vascularisation (5 eyes); anterior staphyloma (1 eye); panophthalmitis (1 eye) and large corneal perforation (1 eye). Conclusions: Optimal results from treatment of corneal ulcers require patients to report early to hospital; upgrading diagnostic facilities and provision of relevant drugs. Key Words: Corneal ulcers, predisposing factors, Nigeria Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 152-15