Evaluating the diagnosis and management of oculomycosis in Ghana

Abstract

Appropriate diagnosis and treatment of oculomycosis is crucial in curbing its associated visual impairment. This study therefore evaluated the diagnosis and management of oculomycosis in Ghana. A cross-sectional survey involving 120 eye care practitioners from six regions of Ghana was conducted. Using a structured questionnaire, information on procedures of diagnosis and management of oculomycosis were collected. Clinical features were considered by 66.7% eye care practitioners in diagnosing oculomycosis, with only 37.5% requesting for laboratory investigations. Fluconazole (79%) and natamycin (44%) were the most commonly prescribed antifungal eye drops by practitioners based on efficacy. Majority of practitioners (59.2%) reported non availability of antifungal eye drops from pharmacies. Age, profession, location of facility and type of facility were strongly associated (P ≤ 0.01-0.001) with the practitioners' diagnostic practice of requesting for laboratory investigations. Diagnosis of oculomycosis in Ghana is based more on clinical features, especially in the district areas, than on microbiological investigations, which does not augur well for better prognosis and management. Treatment is mainly by systemic antifungals, as antifungal eye drops are hard to come by. While a successful therapy was not without some visual consequences, it reduced significantly corneal scarring, blurred vision, and blindness associated with oculomycosis.