Epidemiological and Clinical Profile of Chronic Corneal Disorders: Insights from a Tertiary Care Hospital in Eastern India.
Description
Research Hypothesis and Study Setting This study was carried out at the Regional Institute of Ophthalmology (RIO), Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, a tertiary care referral hospital in Eastern India. We hypothesized that chronic corneal disorders in this population are significantly influenced by lifestyle-related risk factors—such as tobacco and alcohol use—and systemic comorbidities, particularly in rural and agricultural communities. Data Collection and Methodology Data were prospectively collected from 332 patients diagnosed with chronic corneal disorders. Detailed clinical examinations were conducted, including visual acuity testing, slit-lamp evaluations, and history-taking for systemic illnesses and lifestyle habits. Visual acuity was categorized per WHO guidelines, and comorbidities like diabetes, hypertension, and substance use were carefully documented. Statistical analyses included multivariate logistic regression to identify independent risk factors. Key Observations The mean age of patients was 44 years, with a predominance of males (62.7%). The most common diagnoses were corneal opacity (43.1%) and infective keratitis (39.8%), of which fungal infections were the leading cause (61%). More than half of the patients reported decreased vision, and 43.1% had severe visual impairment at presentation. Artificial tears (95.9%) and antibiotics (52.4%) were the most frequently administered treatments. Notably, tobacco use (29.5%) and alcohol consumption (8.1%) emerged as significant risk factors. Regression analysis showed that tobacco use was strongly associated with both infective keratitis (OR = 2.37) and corneal opacity (OR = 1.92). Diabetes was linked to poor treatment outcomes in fungal keratitis (OR = 3.14), while rural residence and agricultural work further increased the risk. Interpretation and Implications The findings highlight the multifactorial nature of chronic corneal diseases in our region, where preventable risk factors significantly affect outcomes. These insights can inform targeted awareness campaigns, guide clinical management, and support the development of region-specific public health strategies to reduce corneal blindness in rural and underserved populations.
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Data Collection Methodology The data presented in this study were collected through a prospective observational approach conducted at the Regional Institute of Ophthalmology (RIO), Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, a tertiary care hospital in Eastern India. The dataset includes information on patient demographics, comorbid conditions, clinical presentation, visual acuity, treatment modalities, and risk factors associated with chronic corneal disorders. Patient data were gathered at the time of clinical presentation to the cornea outpatient department. Standardized clinical examination protocols were followed to document presenting symptoms such as decreased vision, redness, pain, photophobia, and foreign body sensation. Visual acuity was assessed using the best-corrected visual acuity (BCVA) method, categorized according to severity (mild, moderate, or severe visual impairment). Comorbidity status—such as diabetes mellitus, hypertension, tobacco and alcohol use—was recorded based on patient history and existing medical records. Clinical parameters including systolic and diastolic blood pressure and pulse rate were measured using routine hospital instruments. Diagnosis of chronic corneal disorders (e.g., infective keratitis, corneal opacity, dry eye, and bullous keratopathy) was made based on slit-lamp biomicroscopy findings and clinical judgement by ophthalmologists. Subtyping of infective keratitis into bacterial, viral, or fungal categories was performed based on clinical features; however, no microbiological or laboratory methods are mentioned in the dataset. Treatment data were recorded based on the medications prescribed at presentation, including artificial tears, antibiotics, antifungal agents, antivirals, and immunosuppressants. Multivariate logistic regression was used to identify independent risk factors associated with specific corneal conditions. Confidence intervals and p-values were calculated to assess statistical significance, although specific software or statistical packages used are not specified in the dataset. This structured and clinic-based approach provides a reproducible model for assessing the burden and characteristics of chronic corneal diseases in similar hospital-based settings.
Institutions
- Regional Institute of Ophthalmology
- Indira Gandhi Institute of Medical Sciences