Prevalence Of Keratomycosis Among Corneal Ulcer Cases Attending Department of Ophthalmology in A Tertiary Care Hospital at Northern Bihar

Background: Keratomycosis is a major cause of corneal blindness in tropical regions, particularly among rural populations exposed to agricultural trauma. Despite its clinical importance, regional data from Northern Bihar remain limited. Objectives: To determine the prevalence, etiological profile, and therapeutic outcomes of fungal keratitis among corneal ulcer cases in a tertiary care hospital in Northern Bihar. Materials and Methods: This analytic-observational cohort study was conducted at Mata Gujri Memorial Medical College and L.S.K. Hospital, Kishanganj, Bihar, over 23 months (June 2023–May 2025). A total of 105 patients with corneal ulcers were evaluated. Corneal scrapings were examined by KOH mount, Gram staining, and culture on Sabouraud Dextrose Agar. Fungal isolates were identified by colony morphology and LPCB mount. Data were analyzed using SPSS v26. Results: Fungal etiology was confirmed in 42.9% of corneal ulcers. Most patients were 21–40 years old (40%) and male (64.8%), reflecting occupational exposure. Vegetative trauma was the predominant predisposing factor (58.3%). The leading isolates were Aspergillus spp. (55.6%), Fusarium spp. (33.3%), and Candida spp. (11.1%). Bacterial co-infections accounted for 9.5% of cases, with Staphylococcus aureus being the most common. Early diagnosis (< 7 days) correlated with better outcomes—66.7% of fungal cases achieved complete healing. Conclusion: Keratomycosis remains a significant cause of infectious corneal ulceration in Northern Bihar, strongly linked to vegetative trauma and agricultural exposure. Aspergillus species predominate, and early microbiological confirmation with prompt antifungal therapy markedly improves prognosis. Public education on eye protection and early care after ocular injury is essential to reduce preventable blindness in high-risk communities.