Cornea - I Free Papers - aioseducation

Cornea Free Papers
CORNEA - I
Chairman: Dr. G Mukherjee; Co-Chairman: Dr. A K Jain
Convenor: Dr. Beena Desai; Moderator: Dr. Prerna Upadhyaya
Dr. DEBASISH DUTTA: MBBS (1995), NRS Medical College, Calcutta
University, Kolkata; MS (2000), MKCG Medical College, Berhampur
University; Fellowship (2004), Sankara Nethralaya, Chennai. Recepiant of
K.R. Dutta award (1999) in EIZOC, Cuttack. Presently, Consultant, Disha
Eye Hospital and Research Centre, Sheoraphuly, Hooghly, WB.
Contact: 09830216532; E-mail: debasish71@yahoo.com
A New Approach to Management of Corneal
Ulcers by Debridement
Dr. Debasish Dutta, Dr. Arup Bhaumik, Dr. Ayan Mohanta, Dr. Prashant
Kumar Singhal, Dr. Sabitabrata Basu
Visual disability in the developing nations of Asia , Africa and Middle East
is a major public health issue. Cataract is the most common cause but is
easily manageable. The very second cause is corneal opacity resulting from
corneal ulceration. Central Corneal ulceration is a very common occurrence
in the semi urban and rural population. These patients mostly belong to the
financially weaker sections of the society and are involved in agricultural
activities. There is wide geographic and a etiological variation across the globe
and also from region to region.
In the Indian scenario a huge fraction of the agricultural population is affected
by corneal diseases ranging from simple corneal abrasions to microbial
keratitis. This is not the case where farming is highly mechanized.
Microbial keratitis due to bacteria is decreasing at our Disha Eye Hospital
(Hooghly). Self medication or treatment by village quacks cures many of the
bacterial ulcers. This is mainly because of some potent and cheap antibacterial
formulations, which are available over the counter.
So we are left with the dreaded menace of the mycotic keratitis, which is
unequivocally a major cause of ocular morbidity. The problem of fungal
infection of cornea in India is acute as the weather is hot and humid (Tropical)
and to add to the problem are ignorance, illiteracy and poverty.
Medical management of fungal Keratitis is far from satisfactory. Fungi
implicated in keratomycosis rarely cause systemic mycoses. Therapeutic
protocols applicable for systemic mycoses work poorly when applied to
cornea. Polyenes are natamycin and Ampho-B a zoles include Clotrimazole,
Fluconazole and Voriconazole etc. These are mostly fungistatic and not
fungicidal. The drug of choice for filamentous fungi is natamycin suspension.
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