Microsporidial keratoconjunctivitis in Central India: Epidemiological trends and outcomes over 10 years.

PURPOSE: To evaluate the epidemiological characteristics, clinical features, and treatment outcomes of microsporidial keratoconjunctivitis (MKC) over a 10-year period at a tertiary eye care center in central India.

METHODS

This retrospective study analyzed patients diagnosed with MKC between 2015 and 2024. Data from 2005 to 2014 were additionally used to determine hospital-based incidence and prevalence trends. Diagnosis was based on the detection of microsporidial spores in corneal scrapings or characteristic slit-lamp findings. Trends were compared between the two periods (2015-2019 and 2020-2024).

RESULTS

Of 284,211 outpatients seen between 2005 and 2024, 520 (0.2%) were diagnosed with MKC; 393 patients (402 eyes) from 2015 to 2024 were included in the study. The median age was 33 years, with male predominance (64.4%). Most patients were from urban areas (67.9%) and engaged in indoor or sedentary work (81.7%). A significant increase in rural representation and outdoor/manual occupations was observed from 2020 to 2024 ( P = 0.019 and P = 0.018, respectively). Seasonal clustering persisted throughout the rainy season. Minor ocular trauma was reported in 40.7% of cases. The incidence of concurrent diabetes mellitus increased over time. Primary epithelial debridement was performed in 88.1% of patients and was associated with faster epithelial resolution ( P < 0.001). No treatment failures were observed.

CONCLUSIONS

MKC is a seasonally patterned infection with evolving epidemiological characteristics. Increased awareness has led to more diagnoses. Increasing rural representation and associated diabetes require further studies. Although typically self-limiting, epithelial debridement may shorten the resolution time and needs to be explored further as a treatment option.