Browsing by Author "Bajracharya, Leena"
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Publication Bilateral Moraxella Keratitis in a Healthy Person after an Episode of Conjunctivitis: A Case Report(Nepal Medical Association, 2021) Bajracharya, Leena; Rana, Rachana SinghAbstract: Moraxella species are gram-negative diplobacilli and are rare cause of bacterial keratitis. We report a case of a 55-year-old woman presented with pain, redness and profound decrease in vision in both eyes for 2 weeks. One month back she had been treated as acute follicular conjunctivitis elsewhere. She had been treated with ofloxacin drops. On examination, she had central oval full-thickness infiltrate with thinning of cornea and hypopyon in both eyes. She had pseudomembrane in the tarsal conjunctiva. Corneal culture, done separately, showed isolation of Moraxella species, which was resistant to fluoroquinolones. She responded to fortified amikacin and ulcer healed with best-corrected vision of 6/24 and 6/18 in right and left eye respectively. Moraxella keratitis can cause severe keratitis. Conjunctivitis may be complicated by keratitis. Antibiotic resistance can cause problem. Bilateral keratitis should be referred promptly to higher centers if not responding well to treatment.Publication Outcome of Paediatric Microbial Keratitis in Tertiary Eye Center in Nepal(Nepal Paediatric Society (JNPS), 2023) Bajracharya, Leena; Gurung, ReetaAbstract: Introduction: Corneal diseases are important ocular morbidity in childhood in developing countries and microbial keratitis is a common cause for it. Methods: It is a retrospective study of 50 microbial keratitis occurring in children of < 18 years presenting in tertiary eye center in 18 months’ period. Results: Average age of the patients having non-viral infective keratitis was 10.25 years. Sixty-four percent were males. Ninety percent of cases were from rural regions. Patients visited tertiary center at average duration of symptoms of 13.2 days. Twenty-five (50%) cases had history of trauma, of which 16 had trauma while playing. Topical steroids, as risk factor was present in 12 (24%) cases. Six (12%) cases had history suggestive of herpetic keratitis as predisposing factor for microbial keratitis. Thirty-one cases underwent diagnostic corneal scraping. Seven cases showed bacterial growth and three cases fungal growth. Twenty percent of cases had infiltrate size > 25% of corneal surface. Eleven (22%) were with hypopyon. Two cases were perforated at presentation. In total, 37 (74%) of the ulcers healed after treatment, five (10%) underwent therapeutic keratoplasty and eight (16%) were lost to follow up. Out of those healed, 17 had vision of ≥ 6 / 18 and 7 had vision < 3 / 60. Conclusions: Awareness is important for care-takers to avoid trauma in eyes of children. Paediatric microbial cases present late in the tertiary center in our context. Timely referral is important to prevent complications and to avoid need of keratoplasty.