The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal

Introduction: Uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To describe the patterns of refractive errors among children attending the outpatient clinic at the Department of Pediatric Ophthalmology, Lumbini Eye Institute, Bhairahawa, Nepal. Subjects and methods: Records of 133 children with refractive errors aged 5 - 15 years from both the urban and rural areas of Nepal and the adjacent territory of India attending the hospital between September and November 2010 were examined for patterns of refractive errors. The SPSS statistical software was used to perform data analysis. Results: The commonest type of refractive error among the children was astigmatism (47 %) followed by myopia (34 %) and hyperopia (15 %). The refractive error was more prevalent among children of both the genders of age group 11-15 years as compared to their younger counterparts (RR = 1.22, 95 % CI = 0.66 – 2.25). The refractive error was more common (70 %) in the rural than the urban children (26 %). The rural females had a higher (38 %) prevalence of myopia than urban females (18 %). Among the children with refractive errors, only 57 % were using spectacles at the initial presentation. Conclusions: Astigmatism is the commonest type of refractive error among the children of age 5 - 15 years followed by hypermetropia and myopia. Refractive error remains uncorrected in a significant number of children. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5858 NEPJOPH 2012; 4(1): 90-95

Causative organisms in microbial keratitis, their sensitivity pattern and treatment outcome in western Nepal

Introduction: Corneal infection is one of the major causes of monocular blindness in developing countries. Objective: To determine the epidemiological characteristics, predisposing factors, microbiological pattern, sensitivity pattern and treatment outcome of microbial keratitis. Materials and methods: A retrospective analysis of hospital records of 414 patients with diagnosed infective keratitis was done. The outcome measures were microbial isolates, their sensitivity to therapeutic agents and treatment outcome. Results: Of the total, 312 (75.4 %) patients were farmers by profession, 138 (33.3 %) had a history of ocular trauma and 17(4.1 %) were using topical corticosteroids. Among the 138 cases of the corneal ulcer with trauma, 52 (37.68 %) had fungi isolated in culture (RR=0.54, 95% CI = 0.44 – 0.68) and 32 (23.19 %) had a bacterial growth. Cultures were positive in 300 (72.5 %) cases, having 138 (33.3 %) patients with pure fungal infection, 121 (29.2 %) with pure bacterial and 41 (9.9 %) with mixed infection. Fusarium spp was the most common fungal pathogen while Staphylococcus epidermidis was the commonest bacterial isolate. The most sensitive antibiotics for the Gram positive bacteria was cephazolin (84.92 %), while for Gram negative, ciprofloxacin and ofloxacin were the most effective (79.31 %). Of 414 cases of corneal ulcers, 363 (87.7 %) cases healed completely. Conclusion: Microbial keratitis is mostly seen in farmers in this part of the world. Fusarium and Staphylococcus epidermidis were the most common isolates. Cephazoline and ofloxacin were the most effective antibiotics for Gram positive and Gram negative organisms respectively. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5863 NEPJOPH 2012; 4(1): 119-127