{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T10:07:41Z","timestamp":1772273261167,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>The purpose of this study was to report the adverse effects of the COVID-19 pandemic on the clinical outcomes of infectious keratitis in South India.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Two hundred fifty-eight patients presented with infectious keratitis at 6 tertiary care centers when strict travel restrictions were in place from March 24 to May 31, 2020. Case records were collected retrospectively and analyzed for demographics, type of initial treatment, length of delay in presentation, microbiological diagnosis, clinical course, and final treatment outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The mean age of the patients was 49.2 years, with most of them (61.2%) being male. Forty-one patients (15.9%) did not receive any treatment for at least a week after the onset of symptoms. One hundred eight patients (41.9%) presented with severe ulcer (32 had a frank perforation). Resolution of the infection was achieved only in 103 patients (45.6%). A total of 90 patients (39.8%) with ulcers had a perforation, yet only 29 patients (32.2%) could receive keratoplasty because of the unavailability of donor tissues. At the end of 6-month follow-up, 47 patients had anatomical failure (loss of globe) and 12 additional patients had functional failure (total permanent vision loss).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Delay in presentation and acute shortage of donor corneal tissues for emergency keratoplasty because of the COVID-19 pandemic had a grave impact, resulting in irreversible blindness in a significant number of patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ico.0000000000002829","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T23:00:11Z","timestamp":1626994811000},"page":"1474-1481","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Impact of COVID-19 Pandemic on Infectious Keratitis Outcomes: A Retrospective Multicenter Study in Tertiary Eye Hospitals of South India"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2012-9197","authenticated-orcid":false,"given":"Josephine S.","family":"Christy","sequence":"first","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Pondicherry, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya","family":"Mathews","sequence":"additional","affiliation":[{"name":"Cornea and External Diseases Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Rhagavan","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Coimbatore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anitha","family":"Venugopal","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Tirunelveli, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya","family":"Manohar","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Chennai, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuja","family":"Janakiraman","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Salem, India; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preethika","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Madurai, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srujana","family":"Nallobolu","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Services, Aravind Eye Hospital, Pondicherry, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esen K.","family":"Akpek","sequence":"additional","affiliation":[{"name":"Cornea and External Diseases Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"key":"R1-20250728","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1136\/bjo.2006.103028","article-title":"Corneal ulceration in south\u2010east Asia III: prevention of fungal keratitis at the village level in south India using topical antibiotics","volume":"90","author":"Srinivasan","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"R2-20250728","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1136\/bjo.81.8.622","article-title":"Corneal ulceration in the developing world: a silent epidemic","volume":"81","author":"Whitcher","year":"1997","journal-title":"Br J Ophthalmol"},{"key":"R3-20250728","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.survophthal.2018.12.003","article-title":"The persistent dilemma of microbial keratitis: global burden, diagnosis, and antimicrobial resistance","volume":"64","author":"Ung","year":"2019","journal-title":"Surv Ophthalmol"},{"key":"R4-20250728","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1136\/bjo.2005.079533","article-title":"Risk factors for perforation in microbial corneal ulcers in north India","volume":"90","author":"Titiyal","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"R5-20250728","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4103\/0301-4738.29487","article-title":"Infective keratitis: a challenge to Indian ophthalmologists","volume":"55","author":"Srinivasan","year":"2007","journal-title":"Indian J Ophthalmol"},{"key":"R6-20250728","doi-asserted-by":"crossref","first-page":"273","DOI":"10.4103\/0301-4738.53051","article-title":"Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade","volume":"57","author":"Gopinathan","year":"2009","journal-title":"Indian J Ophthalmol"},{"key":"R7-20250728","doi-asserted-by":"crossref","first-page":"423","DOI":"10.4103\/0301-4738.100540","article-title":"Turning the tide of corneal blindness","volume":"60","author":"Oliva","year":"2012","journal-title":"Indian J Ophthalmol"},{"key":"R8-20250728","doi-asserted-by":"crossref","first-page":"198","DOI":"10.4103\/0970-0218.120153","article-title":"Burden of corneal blindness in India","volume":"38","author":"Gupta","year":"2013","journal-title":"Indian J Community Med"},{"key":"R9-20250728","doi-asserted-by":"crossref","first-page":"912","DOI":"10.4103\/ijo.IJO_821_17","article-title":"Fungal keratitis: the Aravind experience","volume":"65","author":"Prajna","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R10-20250728","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.joco.2018.04.001","article-title":"Outcome of therapeutic penetrating keratoplasty in advanced infectious keratitis","volume":"30","author":"Raj","year":"2018","journal-title":"J Curr Ophthalmol"},{"key":"R11-20250728","article-title":"Prevalence and prognosis of corneal perforation in patients diagnosed with fungal keratitis","volume":"28","author":"Dewang","year":"2017","journal-title":"Biomed Res"},{"key":"R12-20250728","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1001\/jamaophthalmol.2017.2914","article-title":"Predictors of corneal perforation or need for therapeutic keratoplasty in severe fungal keratitis: a secondary analysis of the mycotic ulcer treatment trial II","volume":"135","author":"Prajna","year":"2017","journal-title":"JAMA Ophthalmol"},{"key":"R16-20250728","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1016\/S2352-4642(20)30108-5","article-title":"Delayed access or provision of care in Italy resulting from fear of COVID-19","volume":"4","author":"Lazzerini","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"key":"R17-20250728","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1056\/NEJMc2009166","article-title":"Reduced rate of hospital admissions for ACS during covid-19 outbreak in northern Italy","volume":"383","author":"De Filippo","year":"2020","journal-title":"N Engl J Med"},{"key":"R18-20250728","doi-asserted-by":"crossref","first-page":"2871","DOI":"10.1016\/j.jacc.2020.04.011","article-title":"Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic","volume":"75","author":"Garcia","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"R20-20250728","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/j.sapharm.2020.04.007","article-title":"Medication management and adherence during the COVID-19 pandemic: perspectives and experiences from low-and middle-income countries","volume":"17","author":"Kretchy","year":"2021","journal-title":"Res Soc Adm Pharm"},{"key":"R21-20250728","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.4103\/ijo.IJO_1033_20","article-title":"COVID-19 and eye banking","volume":"68","author":"Chaurasia","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"R24-20250728","doi-asserted-by":"crossref","first-page":"e043590","DOI":"10.1136\/bmjopen-2020-043590","article-title":"Impact on health and provision of healthcare services during the COVID-19 lockdown in India: a multicentre cross-sectional study","volume":"11","author":"Raman","year":"2021","journal-title":"BMJ Open"},{"key":"R25-20250728","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1001\/jamaophthalmol.2013.1612","article-title":"Differences in clinical outcomes in keratitis due to fungus and bacteria","volume":"131","author":"Prajna","year":"2013","journal-title":"JAMA Ophthalmol"},{"key":"R26-20250728","first-page":"48","article-title":"Microbial keratitis in Gujarat, Western India: findings from 200 cases","volume":"10","author":"Kumar","year":"2011","journal-title":"Pan Afr Med J"},{"key":"R27-20250728","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4103\/JOCO.JOCO_113_20","article-title":"Delhi infectious keratitis study: update on clinico-microbiological profile and outcomes of infectious keratitis","volume":"32","author":"Acharya","year":"2020","journal-title":"J Curr Ophthalmol"},{"key":"R28-20250728","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.4103\/ijo.IJO_1781_20","article-title":"\u201cRay of light during tough times\u201d\u2013role of gamma irradiated corneal tissue in emergency keratoplasty","volume":"68","author":"Christy","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"R29-20250728","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1136\/bjo.81.11.965","article-title":"Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India","volume":"81","author":"Srinivasan","year":"1997","journal-title":"Br J Ophthalmol"},{"key":"R30-20250728","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.ajo.2015.06.005","article-title":"Demand for tertiary eye care services in developing countries","volume":"160","author":"Subburaman","year":"2015","journal-title":"Am J Ophthalmol"},{"key":"R31-20250728","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.4103\/ijo.IJO_1560_20","article-title":"Use of U-shaped tool for follow up of corneal ulcer cases in the COVID-19 pandemic","volume":"68","author":"Bafna","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"R32-20250728","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1007\/s00417-020-04879-2","article-title":"Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak","volume":"258","author":"Sommer","year":"2020","journal-title":"Graefes Arch Clin Exp Ophthalmol"}],"container-title":["Cornea"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/ICO.0000000000002829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T22:05:52Z","timestamp":1753740352000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ICO.0000000000002829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,21]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/ico.0000000000002829","relation":{},"ISSN":["0277-3740"],"issn-type":[{"value":"0277-3740","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7,21]]},"assertion":[{"value":"2021-03-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}