%0 Journal Article
%T Clinical perspective and outcome of culture-negative microbial keratitis: A retrospective study.
%A Venugopal A
%A Andhare P
%A Rao AV
%A Gunasekaran R
%A Ravindran M
%J Indian J Ophthalmol
%V 72
%N 8
%D 2024 Aug 1
%M 39078956
%F 2.969
%R 10.4103/IJO.IJO_2794_23
%X <B>OBJECTIVE: </B>To study the risk factors, clinical features, and treatment outcomes of patients with culture-negative keratitis (CNK).<BR><B>METHODS: </B>A retrospective data review of 933 patients with CNK was performed from January 2018 to December 2020. The variables such as the history of injury, visual acuity, slit-lamp findings with measurements of size and depth of ulcer, microbiological evaluation, duct patency, blood glucose levels, and treatment were considered, and clinical outcome was analyzed.<BR><B>RESULTS: </B>Of the 933 patients with CNK, 763 (81.8%) were medically managed, with a mean treatment duration of 2.08 ± 1.7 weeks. Among them, 622 (66.7%) were both smear and culture-negative, and 311 (33.3%) showed only smear positivity. Smear-positive patients showed a positive correlation with the history of injury. A higher incidence of fungal growth on repeat culture was observed. Surgical interventions were done only in 18.2% of the patients; the rest were treated with topical medications alone.<BR><B>CONCLUSIONS: </B>High clinical suspicion, differentiation of causative organisms based on clinical findings, and initiating empirical therapy with broad-spectrum antibiotics and antifungals improve the ultimate prognosis in patients with CNK, even though a standard protocol for empirical medical treatment may differ among institutions and surgeons based on their clinical experience and geographical variations.