Epidemiology, risk factors, clinical outcomes, and prognostic factors of infectious keratitis: A tertiary center experience in Qatar

To investigate the infectious keratitis profile, causative agents, underlying risk factors, and clinical outcomes reported over 5 years in Qatar. A retrospective cohort study. A retrospective analysis of all patients who received treatment for infectious keratitis at Hamad Medical Corporation, Qatar, between January 2019 and December 2023 was performed. Data regarding culture results, risk factors for infectious keratitis, visual acuity at the time of presentation, and the clinical course were obtained from medical records and microbiological reports. A total of 143 patients with microbial keratitis were included. The median age was 38 years (30–47.5). 93 (65 %) of patients were male. The mean follow-up duration was 18 ± 3 months. 34 (21.1 %) were culture-positive, and 107 (79.9 %) were culture-negative. Pseudomonas aeruginosa and Staphylococci spp. were the most common pathogens in culture-positive patients ( N = 18, 53 %). Most patients ( N = 104, 72.7 %) had at least one risk factor. Of these, 25 (17.5 %) had two risk factors, and 14 (9.8 %) had three or more. Ocular trauma was the most common risk factor ( N = 45, 31.5 %), followed by contact lens use ( N = 34, 23.8 %) and ocular surface disease ( N = 24, 16.8 %). 133 (93 %) of patients improved with medical treatment alone, while 10 (7 %) required surgical interventions. The mean CDVA (logMAR) improved from 0.78 at presentation to 0.48 at the final follow-up ( p < 0.001). Multivariable regression analysis showed that culture positivity was significantly associated with poorer corneal healing (OR 1.91; 95 % CI 1.49–2.33). While this indicates a robust association, causal inference cannot be established due to the observational study design. Ocular trauma is the major risk factor for infectious keratitis in Qatar. Pseudomonas aeruginosa and Staphylococci spp. were the most common organisms isolated. Awareness campaigns about occupational hazards and ocular safety equipment could help decrease the burden of trauma-related keratitis in the country.