Clinical profile of toxic keratoconjunctivitis after ocular trauma with insect

Abstract

INTRODUCTION: Toxic keratoconjunctivitis is a frequently encountered problem in the subspecialty of cornea. Toxic keratoconjunctivitis can occur as a complication of exposure to various substances. Toxic keratoconjunctivitis due to exposure to many chemicals and medications have been well described in the literature. The present study was carried out to explore the clinical profile of toxic keratoconjunctivitis caused by insect an unknown cause in a tertiary care center in Lumbini zone of western region of Nepal.

METHODS: It was a prospective observational study conducted in cornea clinic of Lumbini Eye Institute, Bhairahawa, Nepal from 1 October 2012 to 30 September 2013. Institutional approval and informed consent was taken. All the patients presented with toxic keratoconjunctivitis caused by insect or unknown causes were included in the study. Patients with other known causes of toxic keratoconjunctivitis like drugs, chemicals were excluded from the study. Detail clinical history, general physical examination and meticulous ophthalmological examination were carried out in all the subjects as per predesigned pro-forma. Patients were followed up after 3 days, 1 week and 2 weeks after initial presentation.

RESULTS: Total 39 patients with toxic keratoconjunctivitis presented in cornea clinic of Lumbini Eye Institute during the study period were enrolled and analyzed. The mean age of the patients was 38.20±15.44 year ranging from 16-75 years. Male were affected more than female. In our study 33 (84.62%) patients were male and only 6 (15.38%) patients were female. Most of patients presented during the month of April and May. Twenty one (53.85%) of our patients noticed some small insects lodged in the eye. Eighteen (56.15%) patients had history of exposure of foreign body but could not identify it as insect. Most of patients noticed exposure of insect or an unknown object in Night (36, 92.31%) and only 3 (7.69%) patients during day time. Mean duration of illness was 2.13±1.19 days ranging from 1 to 5 days. Right eye and left eye were involved equally. Complete healing of lesions occurred in all the patients

CONCLUSION: Toxic keratoconjunctivitis caused by insect or unknown foreign body is a frequently encountered problem seen in summer months in a tertiary care center in Lumbini zone of western region of Nepal. With treatment all the patient had good out come in form of complete healing of ocular lesions.

DOI: http://dx.doi.org/10.3126/jucms.v1i4.9573

Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 41-44