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Peer-reviewedCC BY 4.0PLOS One

Age-related differences in the clinical and microbiological profile of pediatric microbial keratitis in Eastern India

  • Rakhi Kusumesh1
  • Nancy Panday2
  • Lalan Kumar Arya3
  • Rizwan Ahmar4
  • Anita Ambasta5
  • Anita Kumari6
  • Namrata Kumari
  • Bibhuti Prassan Sinha
  • Nilesh Mohan
6 affiliations
  1. 1Cornea and ocular surface services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
  2. 2Microbiology services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
  3. 3Department of paediatrics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
  4. 4Community services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
  5. 5Department of microbiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
  6. 6Glaucoma services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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Abstract

Purpose: To evaluate the demographics, predisposing factors, microbiological profile, management, and outcomes of pediatric microbial keratitis in Eastern India, with particular emphasis on age-related differences. Materials and methods: This prospective study included children with clinically diagnosed microbial keratitis between April 2024 and September 2025. Clinical, microbiological, nutritional, treatment, and outcome data were recorded. Children were categorized into two age groups: ≤ 5 years and >5 years for comparative analysis. Results: Ninety-nine eyes of 86 children were analyzed. The mean age was 5.9 ± 4.8 years, and 42 of 86 children were aged ≤5 years. Bilateral keratitis was observed exclusively in children ≤5 years (p < 0.05). Systemic risk factors such as undernutrition and vitamin A deficiency, diarrhea, and fever were significantly more common in children ≤5 years; in contrast, corneal injury was the predominant risk factor in children >5 years. Mean duration of presentation, ulcer size, and ulcer severity did not differ significantly between the two age groups, although perforation at presentation was more frequent in children >5 years. Fungal keratitis was significantly more common in children >5 years, whereas unidentified cases were more frequent in ≤5 years. Corneal ulcers resolved with medical therapy alone in 59.6% of eyes. Surgery was required in 40.4% of eyes overall, including 18.2% of eyes in children ≤5 years and 22.2% in children >5 years. At 3 months, corneal opacity was the most common outcome. Conclusion: Pediatric microbial keratitis showed clear age-related differences. Younger children were more often affected by systemic and nutritional vulnerability with predominantly sterile or bacterial keratitis, whereas older children had more trauma-related and fungal disease. Early referral, improved nutritional support, and timely globe-preserving management may reduce visual loss. Conference presentation: This research work has been selected for presentation at ARVO 2026, Denver, Colo. May 3 - 7

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Cite

BibTeXRIS
BibTeX
@article{kusumesh2026agerelated,
  title = {{Age-related differences in the clinical and microbiological profile of pediatric microbial keratitis in Eastern India}},
  author = {Rakhi Kusumesh and Nancy Panday and Lalan Kumar Arya and Rizwan Ahmar and Anita Ambasta and Anita Kumari and Namrata Kumari and Bibhuti Prassan Sinha and Nilesh Mohan},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0359943},
  url = {https://doi.org/10.1371/journal.pone.0359943},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Age-related differences in the clinical and microbiological profile of pediatric microbial keratitis in Eastern India
AU  - Rakhi Kusumesh
AU  - Nancy Panday
AU  - Lalan Kumar Arya
AU  - Rizwan Ahmar
AU  - Anita Ambasta
AU  - Anita Kumari
AU  - Namrata Kumari
AU  - Bibhuti Prassan Sinha
AU  - Nilesh Mohan
PY  - 2026
DA  - 2026/10/14
JO  - PLOS One
DO  - 10.1371/journal.pone.0359943
UR  - https://doi.org/10.1371/journal.pone.0359943
AB  - Purpose: To evaluate the demographics, predisposing factors, microbiological profile, management, and outcomes of pediatric microbial keratitis in Eastern India, with particular emphasis on age-related differences. Materials and methods: This prospective study included children with clinically diagnosed microbial keratitis between April 2024 and September 2025. Clinical, microbiological, nutritional, treatment, and outcome data were recorded. Children were categorized into two age groups: ≤ 5 years and >5 years for comparative analysis. Results: Ninety-nine eyes of 86 children were analyzed. The mean age was 5.9 ± 4.8 years, and 42 of 86 children were aged ≤5 years. Bilateral keratitis was observed exclusively in children ≤5 years (p < 0.05). Systemic risk factors such as undernutrition and vitamin A deficiency, diarrhea, and fever were significantly more common in children ≤5 years; in contrast, corneal injury was the predominant risk factor in children >5 years. Mean duration of presentation, ulcer size, and ulcer severity did not differ significantly between the two age groups, although perforation at presentation was more frequent in children >5 years. Fungal keratitis was significantly more common in children >5 years, whereas unidentified cases were more frequent in ≤5 years. Corneal ulcers resolved with medical therapy alone in 59.6% of eyes. Surgery was required in 40.4% of eyes overall, including 18.2% of eyes in children ≤5 years and 22.2% in children >5 years. At 3 months, corneal opacity was the most common outcome. Conclusion: Pediatric microbial keratitis showed clear age-related differences. Younger children were more often affected by systemic and nutritional vulnerability with predominantly sterile or bacterial keratitis, whereas older children had more trauma-related and fungal disease. Early referral, improved nutritional support, and timely globe-preserving management may reduce visual loss. Conference presentation: This research work has been selected for presentation at ARVO 2026, Denver, Colo. May 3 - 7
SN  - 1932-6203
ER  -