In south Asian countries, the incidence of MK has been reported to be as high as 113/100,000 in southern India and 799/100,000 in Nepal. It ranges from 6–52/100,000 in “Western” nations such as the United Kingdom (UK), the United States of America (USA) and Australia.

The incidence of MK varies greatly depending on location and population. As a subset of ocular surface infections, MK cases are more visually devastating, often require hospital admission for intensive topical antimicrobial therapy, and are associated with a greater economic burden to patients, healthcare and society. Perforations of the cornea may arise within one to two days from particularly virulent infections.

This allows deeper penetration of microbes with further corneal injury from both the pathogen and the host immune response, exacerbating permanent vision loss through scarring and vascularization. The cornea is especially vulnerable to microbial infection due to its avascular nature and poor visual outcome may result from a lack of aggressive, targeted antimicrobial therapy. Risk factors for MK include contact lens use, ocular surface disease and trauma. It is caused by infection of the cornea by microorganisms, especially when the surface epithelium is compromised. Microbial keratitis (MK) is a serious and sight-threatening ocular emergency that requires prompt diagnosis and intensive topical antimicrobial therapy to salvage vision. Minimizing the duration of admission, or opting for outpatient management where appropriate, would significantly reduce the cost of treatment for microbial keratitis. Our findings demonstrate that microbial keratitis represents a significant economic burden for eye-related diseases and the key driving factor for the cost is the length of admission. The total annual cost of microbial keratitis within Australia is estimated to be AUD 13.58 million (USD 9.23 million). Median cost for all presentations of microbial keratitis was AUD 8013 (USD 5447), with costs significantly increasing with admission. A total of 59.3% of patients were admitted, with a median length of admission of 7 days. Our study showed the most commonly occurring pathogens were Herpes Simplex (16%), Staphylococcus aureus (15.1%) and Pseudomonas aeruginosa (14.3%).

A wide variety of costs were considered to determine the economic burden, using standardized data from the Independent Hospital Pricing Authority and the cost of personal income loss. A retrospective review of 160 cases of microbial keratitis was performed, over a 5-year period from 2015–2020. The purpose of this study was to analyse the causative organisms of microbial keratitis, its presentation and economic burden from a tertiary referral hospital in Australia. The causative organism varies by region, and most cases require intensive antimicrobial therapy. Microbial keratitis is the most common cause of infective vision loss.

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