Pattern of bilateral blinding corneal disease in patients waiting for keratoplasty in a tertiary eye care centre in northern India

Abstract

Objectives: To determine the clinical profile, demographic characteristics, and socioeconomic status in patients with bilateral blinding corneal disease who are waiting for keratoplasty.

Methods: Patients with bilateral blindness from corneal diseases, who were admitted for keratoplasty in the cornea services of a tertiary eye care center in Northern India from May 1, 2004, to December 31, 2004, were enrolled in the study. The clinical presentation, demographic details, and socioeconomic status of the patients were noted and analyzed.

Results: Fifty-nine patients with bilateral blindness from corneal disease were included in the study, of which 56 (95%) had bilateral corneal disease resulting from similar etiology and three (5%) of different etiology in both eyes. Twenty-two patients (37%) had simultaneous onset and 37 patients (63%) had separate onset of the corneal disease with subsequent involvement of the fellow eye and a mean interval of 16.4 years. Infection was the predominant etiologic diagnosis in patients with bilateral similar etiologic disease (62.5%). The pinhole visual acuity was 1/60 or less in the better eye in 45 patients and 1/60 to 3/60 in eight and 3/60 to 6/60 in six patients. Fifty-four patients (92%) lived in rural areas, whereas only five patients (8%) lived in urban areas. Only 18 patients (31 %) were gainfully employed. Thirty patients (51 %) were illiterate.

Conclusion: Corneal infection is the most common cause of bilateral corneal blindness. There is a high frequency of involvement of one eye with subsequent involvement of the other eye at a later date. This is more commonly seen in the rural population, particularly in those belonging to a lower socioeconomic stratum and those who are illiterate and tend to be ignorant about proper eye care.