RT Journal Article SR Electronic T1 Epidemiology and clinical outcomes of microbial keratitis in South East Nepal: a mixed-methods study JF BMJ Open Ophthalmology JO BMJ Open Ophth FD BMJ Publishing Group Ltd SP e001031 DO 10.1136/bmjophth-2022-001031 VO 7 IS 1 A1 Lila Raj Puri A1 Helen Burn A1 Abhishek Roshan A1 Ramanand Biswakarma A1 Matthew Burton YR 2022 UL http://bmjophth.bmj.com/content/7/1/e001031.abstract AB Objective To describe the epidemiology of microbial keratitis in patients presenting to a tertiary eye hospital in South East Nepal alongside qualitative interviews exploring patient perspectives on barriers to accessing eye care services.Methods and analysis All patients with microbial keratitis (>16 years) presenting to Sagarmatha Choudhary Eye Hospital, Nepal between 1 May 2017 and 31 July 2017 were recruited. Data were collected on patient demographics, precipitating factors and pathway to care. Clinical examination was performed and microbiological samples collected. Visual acuity was measured at final follow-up. Semistructured interviews and focus group discussions explored the patient journey and barriers to accessing care.Results We recruited 174 participants; 88 (51%) were male (mean age of 47 years) and 126 (72%) were farmers. Ocular trauma with vegetative matter was reported by 79 (45%) and 84 (48%) had fungal infections. Visual acuity was <3/60 in 107 (61%) of affected eyes at presentation, reducing to 73 (42%) at last follow-up. Factors associated with poor visual outcome were trauma with vegetative matter, delayed presentation and poor visual acuity at presentation. Qualitative interviews with 40 patients identified lack of awareness of the disease and available services, poor knowledge and practice of community health workers and lack of affordability and accessibility of treatment as important barriers.Conclusion The epidemiology of microbial keratitis in this region was similar to other tropical regions. Patient interviews highlighted need for public health awareness campaigns on microbial keratitis, training of community health staff on the urgency of this condition and improvements in accessibility and affordability of ocular treatments.Data are available on reasonable request. Data are available on request.