Abstract
Background: Microbial keratitis (MK) is a potentially sight-threatening condition with an annual incidence of 2 million cases globally. The present study is aimed at reviewing the treatment options and outcomes for MK in 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 in 13 (13.3%) cases. Fusarium (6) and Aspergillosis (4) were main fungus identified. Topical antibiotic 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 treated, 75 [41.2%(95% Confidence interval 34.3, 48.6)] eyes had regained vision better than 20/60 (normal functional vision) at six 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. Infection due to Staphylococcus and Streptococcus had poor visual recovery. The eyes with MK due to Pseudomonas had remarkable visual gain after treatment.
Conclusion: Management of MK at a tertiary hospital had good outcomes, and underlying causes like late presentation and uncontrolled diabetes need to be addressed concurrently.

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