Microbial Keratitis In Children : A 10 Year Report

Microbial keratitis is a serious vision-threatening condition. The management of microbial keratitis in children is particularly complicated by the children’s inability to cooperate during examinations and the lack of information prior to presentation. This condition can lead to an anatomical and functional loss of the eyeball, and therefore constitutes a therapeutic emergency. 

This is a retrospective study from October 2012 to July 2022 including 162 children hospitalized for corneal abscesses in the ophthalmology department of Casablanca. 

Retrospective study

The average age was 4.7 years. sex ratio of 1.43. Visual acuity at admission was difficult to determine in 85% of cases. The keratitis were unilateral except for 1 patient who had a bilateral abscess. It was central in 50% of cases, and an anterior chamber reaction such as hypopyon was found in 15% of patients. Ocular trauma was the leading cause of abscess in our series (47%). A corneal swab was taken in 72% of patients, 36% of which had positive cultures, with a predominance of Gram+ bacteria. 74% of patients received local antibiotic therapy with fortified eye drops (Fortum - Vancomycin). 
The evolution was favorable in the majority of cases, however the persistence of a sequential corneal opacity was the main complication found 

Microbial keratitis are a serious pathology. The visual prognosis is always at stake when the visual axis is affected, and leads to a risk of functional amblyopia.  An early and adapted management allows to improve the prognosis of corneal abscesses. Upstream, prevention of trauma and awareness of the consequences are essential to reduce the rate of corneal abscesses.