Epidemiological and Clinical Profile of Chronic Corneal Disorders: Insights from a Tertiary Care Hospital in Eastern India.

Research Hypothesis and Study Setting
This study was carried out at the Regional Institute of Ophthalmology (RIO), Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, a tertiary care referral hospital in Eastern India. We hypothesized that chronic corneal disorders in this population are significantly influenced by lifestyle-related risk factors—such as tobacco and alcohol use—and systemic comorbidities, particularly in rural and agricultural communities.

Data Collection and Methodology
Data were prospectively collected from 332 patients diagnosed with chronic corneal disorders. Detailed clinical examinations were conducted, including visual acuity testing, slit-lamp evaluations, and history-taking for systemic illnesses and lifestyle habits. Visual acuity was categorized per WHO guidelines, and comorbidities like diabetes, hypertension, and substance use were carefully documented. Statistical analyses included multivariate logistic regression to identify independent risk factors.

Key Observations
The mean age of patients was 44 years, with a predominance of males (62.7%). The most common diagnoses were corneal opacity (43.1%) and infective keratitis (39.8%), of which fungal infections were the leading cause (61%). More than half of the patients reported decreased vision, and 43.1% had severe visual impairment at presentation.

Artificial tears (95.9%) and antibiotics (52.4%) were the most frequently administered treatments. Notably, tobacco use (29.5%) and alcohol consumption (8.1%) emerged as significant risk factors. Regression analysis showed that tobacco use was strongly associated with both infective keratitis (OR = 2.37) and corneal opacity (OR = 1.92). Diabetes was linked to poor treatment outcomes in fungal keratitis (OR = 3.14), while rural residence and agricultural work further increased the risk.

Interpretation and Implications
The findings highlight the multifactorial nature of chronic corneal diseases in our region, where preventable risk factors significantly affect outcomes. These insights can inform targeted awareness campaigns, guide clinical management, and support the development of region-specific public health strategies to reduce corneal blindness in rural and underserved populations.