Clinical and epidemiological characterization of patients with fungal corneal ulcer

Abstract

Corneal ulcer caused by infectious keratitis of fungal origin is recognized as a frequent problem worldwide and in Cuba. In order to characterize clinical and epidemiological aspects in patients with fungal corneal ulcer admitted to the Ophthalmology service of the Celia Sánchez Manduley Hospital, a descriptive, longitudinal, prospective study was conducted in a universe of 47 patients during the period from 2022 to 2024. Theoretical, empirical, and statistical methods were applied. Study variables included: age, sex, origin, occupational activity, symptoms and signs, time since trauma, location and size of the ulcer, affected eye, type of fungus, predisposing factors, treatments, hospital stay, and data extracted from medical records and the form designed by the researchers. The results obtained were: mean age of 50 years, male sex, agricultural workers; all reported symptoms of scant or no secretions and decreased visual acuity; signs included presence of corneal infiltrate, elevated surface, and irregular edges; ulcer location was central and medium-sized, with predominance of filamentous fungus. Trauma from plant material was confirmed as a local predisposing factor, along with systemic factors and a history of arterial hypertension; the most commonly used treatment was amphotericin B, with satisfactory outcomes. In conclusion, the presence of ocular trauma from plant material is recognized as the most frequent cause of fungal corneal ulcers, and therapy with fortified amphotericin B eye drops and semisolid ketoconazole yielded favorable results.