Abstract
Background: Microbial keratitis (MK) is a potential sight-threatening condition with an annual incidence of 2 million cases globally. The present study aimed at reviewing the treatment options and outcomes of MK for 10 years at the ophthalmic unit of a tertiary hospital in central Saudi Arabia.
Methods: This retrospective review of the health records was conducted in 2020 reviewing the records from 2010 to 2019. Microbial profile and treatment outcomes were analyzed. Persons with the best corrected visual acuity (BCVA) at last follow-up, as well as eyes eviscerated, were estimated.
Results: A total of 181 MK cases were considered for the study, among which culture was positive in 98 (54.1%) patients. Gram-positive and Gram-negative bacteria were in 50 (49%) and 35 (35.7%) cases, respectively. Fungus MK was present in 13 (13.3%) cases. Fusarium (6) and Aspergillus (4) were main fungi identified. Topical antibiotics included Ceftazidim + Cefazolin (113; 62.4%), Cefazolin + Gentamycin (45; 24.8%), and Ceftazidim + Vancomycin (23; 12.7%). Anit-fungals included Amphoterecin (13) and Natamycin (13) cases among the 181 eyes were treated. 75 {41.2% [95% confidence interval (CI) 34.3, 48.6]} eyes had regained vision better than 20/60 (normal functional vision) at 6 months after completion of treatment. The rate of anatomic failure (removal of eyeball) was 2.2% (95% CI = 0.1, 4.4). Final BCVA was <20/200 in 47 (26%) eyes. Infections due to Staphylococcus and Streptococcus had poor visual recovery. Eyes with MK due to Pseudomonas had remarkable visual gain after treatment.
Conclusion: The management of MK at a tertiary hospital had good outcomes, but the underlying causes like late presentation and uncontrolled diabetes need to be addressed concurrently.

Key words: Microbial Keratitis, antibiotics, anti-fungal, ocular infection, vision