Pythium corneal ulcer in Ramathibodi Hospital.

This is a retrospective study of corneal ulcers caused by Pythium insidiosum in Ramathibodi Hospital from 1988 to 1998. The clinical data was from the medical records of 10 patients, of which 8 had complete information. Mean age of the patients was 49.8 years old and seven were farmers. Initial visual acuity was mostly below finger counts. All manifested as fungal corneal ulcers, diagnosis of Pythium insidiosum was confirmed by histology. After failed medication, penetrating keratoplasty (PKP) was performed in order to remove the infected tissue. One patient had only anterior lamella keratectomy performed and was completely cured. Seven other patients had to have their eyes removed (evisceration or enucleation) to be cured. The study shows that Pythium corneal ulcer is rare but devastating. Patients with an agricultural occupation are most at risk. Antibiotics and antifungals could not control or cure this disease, so education for people at high risk is advocated.