Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy

Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy Kingsley Badu, Abigail Oforiwaa Boateng, Isaiah Osei Duah Junior, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4656890/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract Background Ocular mycoses have a debilitating impact on ocular health and quality of life. However, the burden and etiology of ocular mycoses and the efficacy of clinical antifungal agents used in the management of ocular fungal infections remain unclear. The study assesses the prevalence of ocular fungal pathogens and multi-drug resistance patterns, and further explored native medicinal plants as a source of antifungal agents in Ghana. Methods In this multicenter, cross-sectional study, biographic, medical, and ophthalmic data were collected using a structured questionnaire, and conjunctival swabs and corneal samples were collected for microbiological characterization and antifungal susceptibility testing. Patient demographic and clinical data were stratified by sex and differences were tested using chi-squared analysis. Microbiological data were presented as proportions, means, and standard deviations. Bivariate logistic regression was used to test the association between patient characteristics and the likelihood of isolating fungal pathogens from the eyes of persons with presenting eye infections. Results Approximately ten percent (9.36%) of ocular specimens were positive for fungal culture with the predominant fungal etiology being Candida albicans. Multi-drug resistance was observed for clinically used antifungal agents; amphotericin B and fluconazole, itraconazole, terbinafine. Alternatively, ethanolic extracts of Cinnamomum verum ( C. verum ) and Syzygium aromaticum ( S. aromaticum ), demonstrated potent fungistatic and fungicidal activity against the common implicated pathogen, Candida albicans ( C. albicans ). Conclusion Overall, the study broadens our understanding of the pathogenesis of ocular mycoses in Ghana and the implications of clinical use of antifungal treatments. Leveraging on the medicinal plant screening, we propose characterization of the bioactive compound(s) in C. verum and S. aromaticum for clinical translation into ocular antifungal therapeutics. Health sciences/Medical research/Epidemiology Biological sciences/Microbiology/Fungi/Fungal pathogenesis Health sciences/Diseases/Infectious diseases/Fungal infection Health sciences/Health care/Public health/Epidemiology Ocular mycoses antimicrobial resistance natural products phytoconstituents lead-compounds Cinnamomum verum and Syzygium aromaticum drug discovery Figures Figure 1 Figure 2 Figure 3 Background Fungal eye infections or oculomycosis, are caused by various species of fungi that can affect different parts of the eye, such as the conjunctiva, cornea, eye lids, as well as the interior of the eye; clinically termed mycotic conjunctivitis, keratitis, blepharitis, and endophthalmitis. Although relatively rare, mycotic eye infections can cause significant morbidity and vision loss. 1 Unlike bacterial eye infections, epidemiologic estimates of fungal eye infections are limited due to the diagnostic challenges. However, recent studies estimate the annual incidence of keratomycoses to be 1,051,787 cases per year, with the highest burden recorded in Asia and Africa regions 2,3 . The burden of ocular mycoses varies by geographic region, populations, seasonal variations, and innate predisposing factors 4,5 . In particular, the burden remains high in tropical and subtropical regions owing to suitable high humidity for spore growth, and increase exposure to vegetative matter 6,7,8 . Other intrinsic (impaired immunity resulting in cancer, HIV/AIDS and diabetes), and extrinsic (contaminated contact lens, ocular trauma or surgery, use of topical steroids, and antibacterials) 8 ,9 factors increase the likelihood of fungal eye infections. The prevalence of fungi pathogens implicated in presenting eye infections in Ghana remains unknown. A staggering number of fungal pathogens have been implicated in oculomycosis, with an increase in incidence due to seasonal variations 9 . While filamentous fungi (Fusarium, Aspergillus, Acremonium, and Penicillium species) remains the cause of oculomycosis in tropical and subtropical regions, yeast and yeast-like fungi (Candida, Cryptococcus, and Malassezia species) assumes a significant etiology in temperate regions. 8,9,10 . Clinically, patients with ocular mycoses present with symptoms of ocular pain, redness, lacrimation, watery to thick mucus discharge, photophobia, and decreased visual acuity, which are usually misinterpreted by ophthalmologists as bacterial infections. Such clinical misdiagnosis of suspected external ocular and periocular infections of fungal etiology may exacerbate into corneal perforation and consequently compromise the middle and inner tunics of the eye, resulting in panuveitis, endophthalmitis, or even loss of the eye. 7,11 . The duration of treatment for ocular fungal infections varies depending on the fungus involved and the severity of the disease 12 . Such a disease prognosis emphasizes accurate diagnosis and timely initiation of ophthalmic treatment. However, in resource-limited settings such as Ghana, due to the lack of rapid molecular diagnostics and high-throughput screening facilities, consulting eye care providers are accustomed to observing clinical features as the basis for diagnosis and management of oculomycosis. Specifically, eye care providers perform a comprehensive patient history to collect patient symptoms, and gross ophthalmic assessments using slit lamp biomicroscopy, ophthalmoscopy, and visual acuity to identify peculiar clinical signs and apply broad-spectrum antimicrobial therapy. 13,14,15 . To date the fungi pathogens involved in eye infections among patients in Ghana is lacking. Furthermore, the routine method of clinical diagnosis is not only flawed by the inability to determine the causal etiology, but also perpetuates multi-drug resistance (MDR) due to the increase patronization of broad-spectrum antimicrobials 16 . MDR has receives a significant attention in developed countries with implementation of various initiatives 17,18,19,20 . However, such effort is limited in resource constraint settings such as Ghana where there is poor regulatory compliance and adherence to antimicrobial handling and use, and limited accessibility of national antimicrobial policy guidelines 21 . Of note, antifungal agents such as polyenes (natamycin, nystatin, and amphotericin B), allylamines (terbinafine), azoles (fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and echinocandins classes are utilize in the management of fungi infections including ocular mycosis 22 . Echinocandins, the polyenes, allylamines, and azole class of antifungal medications are readily available and commonly used by medical and eye care providers in Ghana 23,24,25 . Current trends in medicine and public health show increasing AMR and MDR to clinically used antimicrobial agents such as antifungals. However, there remains a paucity of evidence on the antifungal susceptibility status of commonly administered antifungal drugs used by ophthalmic clinicians in Ghana. Natural products represent a significant source of phytoconstituents with a promising propensity for development into novel drug therapies 26 . As a semi-arid region, Ghana is home to an array of medicinal plants traditionally utilized to treat various infections owing to their beneficial phytochemicals such as alkaloids, flavonoids, tannins, glycosides, saponins, triterpenoids, and phytosterols 27,28 . The vegetative parts of plants such as Aspilia Africana (A. Africana), Chromolaena odorata (C. odorata), C. verum, S. aromaticum, Senna alata (S. alata) are known for their antifungal activity 29,30 . However, the fungistatic and fungicidal potential of these medicinal plants against ocular microbes have not been previously studied. Our preliminary elucidation of the antifungal potential of these medicinal plants against ocular fungal isolates could gauge the bioprospecting of bioactive lead compounds with potential for clinical development into novel treatment therapy for oculomycosis. Therefore, the primary objective of this study elucidates the fungal pathogens implicated in clinically presenting eye infections and ascertain the antifungal susceptibility of antifungal agents commonly used by clinicians to manage oculomycosis in Ghana. Additionally, the study explore five different Ghanaian medicinal plants as potential source for leads bioactive compounds for treating oculomycosis. Altogether, the primary outcome of our study provides regional specific estimates on the prevalence and commonly implicated fungi pathogen in ocular infections and importantly guide ophthalmic clinicians on their choice of antifungal agents to clinically manage oculomycosis. To this end, the completion of the secondary aim remains essential to inform translational studies in the discovery of novel effective antifungal therapies for oculomycosis. Results Biographic and medical data of patients presenting with eye infections in Ghana Table 1 presents biographic and medical data of the patients enrolled in the study. Of the 248 patients with presenting exterior eye infections, majority were females (62.9%), of median age of 30.50 (Interquartile range; 43.75) years. Most of the patients were aged between 0-18 years (35.9%), of Akan ethnicity (90.7%), rural residence (59.7%), adhere to the Christian religion (91.5%), and possess a secondary highest level of education (33.5%). There was a significant variation in males and females in terms of occupation (p < 0.001), with most patients’ occupation category being non-farmers (74.6%) and with a single marital status (56.9%). Of the medical conditions, a significantly higher female compared to males were having hypertension (15.7% versus 4.4%, p = 0.013), currently on medications (21.8%) and with a significantly higher female on anti-hypertensive/antidiabetic class of medications compared to their male counterparts (15.7% versus 4.0%, p = 0.007) as shown in Table 1. Table 1: Biographic and medical data of study participants Variables Total (N = 248) Females (N=156, 62.9%) Males (N=92, 37.1%) p-value % (frequency) % (frequency) % (frequency) Biographic characteristics Age group (years) 0-18 35.9 (89) 20.2 (50) 15.7 (39) 0.237 19-44 29.4 (73) 20.2 (50) 9.3 (23) ≥45 34.7 (86) 22.6 (56) 12.1 (30) Ethnicity Akan 90.7 (225) 58.1 (144) 32.7 (81) 0.458 Ewe 1.2 (3) 0.8 (2) 0.4 (1) Northerner 8.1 (20) 4.0 (10) 4.0 (10) Residence Rural 59.7 (148) 39.5 (98) 20.2 (50) 0.189 Urban 40.3 (100) 23.4 (58) 16.9 (42) Religion Atheist 0.8 (2) 0.8 (2) 0.0 (0) 0.321 Christian 91.50 (227) 56.5 (140) 35.1 (87) Muslim 7.7 (19) 5.6 (14) 2.0 (5) Highest level of education None 20.6 (51) 14.5 (36) 6.0 (15) 0.578 Preschool 8.9 (22) 5.2 (13) 3.6 (9) Primary 26.2 (65) 17.3 (43) 8.9 (22) Secondary 33.5 (83) 19.8 (49) 13.7 (34) Tertiary 10.9 (27) 6.0 (15) 4.8 (12) Occupation Barber 0.4 (1) 0.4 (1) 0.0 (0) <0.001 Beautician 3.2 (8) 2.8 (7) 0.4 (1) Businessman/woman 2.4 (6) 1.6 (4) 0.8 (2) Construction Worker 2.0 (5) 0.0 (0) 2.0 (5) Dressmaking 2.0 (5) 2.0 (5) 0.0 (0) Farming 12.1 (30) 8.1 (20) 4.0 (10) Pastor 0.8 (2) 0.4 (1) 0.4 (1) Student 33.1 (82) 19.8 (49) 13.3 (33) Trading 14.9 (37) 12.5 (31) 2.4 (6) Transport Business 2.0 (5) 0.0 (0) 2.0 (5) Unemployed 13.3 (33) 8.9 (22) 4.4 (11) Wage or Salary Worker 10.9 (27) 6.5 (16) 4.4 (11) Welding 2.8 (7) 0.0 (0) 2.8 (7) Occupation (Cat) Farmers 12.1 (30) 8.1 (20) 4.0 (10) 0.774 Non-farmers 74.6 (185) 46.0 (114) 28.6 (71) Unemployed 13.3 (33) 8.9 (22) 4.4 (11) Marital status Cohabiting 2.0 (5) 0.8 (2) 1.2 (3) 0.087 Divorced 14.5 (36) 11.7 (29) 2.8 (7) Married 26.6 (66) 15.7 (39) 10.9 (27) Single 56.9 (141) 34.7 (86) 22.2 (55) Medical characteristics Medical conditions Diabetes 6.0 (15) 5.2 (13) 0.8 (2) 0.049 Hypertension 20.2 (50) 15.7 (39) 4.4 (11) 0.013 Peptic ulcer 4.8 (12) 4.0 (10) 0.8 (2) 0.133 Sexually transmitted diseases 0.8 (2) 0.0 (0) 0.0 (2) 0.064 Others 2.8 (7) 1.2 (3) 1.6 (4) 0.265 Currently taking any medication No 78.2 (194) 47. 2 (117) 31 (77) 0.109 Yes 21.8 (54) 15.7 (39) 6.0 (15) Class of medications Antibiotics 4.0 (10) 2.4 (6) 1.6 (4) 0.846 Antihypertensives and antidiabetics 19.8 (49) 15.7 (39) 4.0 (10) 0.007 Antiretroviral 0.8 (2) 0.0 (0) 0.8 (2) 0.064 Antimalarial 0.4 (1) 0.4 (1) 0.0 (0) 0.442 Antiglaucoma 0.4 (1) 0.0 (0) 0.4 (1) 0.192 Herbal concoction 0.4 (1) 0.0 (0) 0.4 (1) 0.192 N, frequency; %, percentage frequency Ophthalmic data of patients presenting with eye infections in Ghana Table 2 shows the ophthalmic data of study participants. Many of the patients reported to have had both eyes affected (57.4%) with the conjunctiva being the most common site affected (94.4%). Most of the patients had previously used antimicrobials (67.3%), have had previous eye infections (63.7%) and a significantly higher proportion of females with previous application of mascara (p <0.001) and with duration of infection less than one-week (47.8%).With respect to monocular visual acuity, majority of patients had right eye visual acuity better than 6/18 (62.5%), followed by 3/60 -1/60 (11.7%) and with a fewer having visual acuity within the ranges of 6/24 to 6/60 (9.7%). Most patients had a left visual acuity within the ranges of 6/5 -6/6 (67.3%) and fewer proportion (6.9%) having visual acuity better than 6/24 but worse than 6/60. The most common patient-presenting symptoms were hyperemia/redness (59.3%), itching (58.1%) and eye pain (51.6%) and a smaller proportion with falling lashes (3.6%). The distribution of clinical presentations was as follows: conjunctivitis (66.1%), keratoconjunctivitis (14.5%), keratitis (8.1%), blepharoconjunctivis (9.6%), ocular trauma (2.8%), hordeolum (2.0%), preseptal cellulitis (0.8%), ophthalmia neonatorum (0.4%), uveitis (0.4%) and endophthalmitis (0.4%). Additionally, other associated conditions included dry eye syndrome (23.4%), headaches (10.1%), pterygium (5.6%), and pinguecula (2.0%) as shown in Table 2. Table 2: Ophthalmic data of the study participants Variables Total (N = 248) Females (N=156, 62.9%) Males (N=92, 37.1%) p-value % (frequency) % (frequency) % (frequency) Eyes affected Oculus dexter 21 .0 (52) 11.7 (29) 9.3 (23) 0.488 Oculus sinister 21.8 (54) 14.1 (35) 7.7 (19) Oculus uterque 57.3 (142) 37.1 (92) 20.2 (50) Site of the eye affected Eyelids/lashes 16.9 (42) 9.7 (24) 7.3 (18) 0.396 Conjunctiva 94.4 (234) 60.5 (150) 33.9 (84) 0.110 Cornea 16.9 (42) 8.1 (20) 8.9 (22) 0.024 Risk factors Previous eye infections 63.7 (158) 41.9 (104) 21.8 (54) 0.207 Previous use of antimicrobials 67.3 (167) 44.4 (110) 23.0 (57) 0.165 Previous use of contact lenses 0.4 (1) 0.4 (1) 0.0 (0) 0.442 Previous use of spectacles 23.8 (59) 16.5 (41) 7.3 (18) 0.230 Previous ocular trauma 31.0 (77) 18.1 (45) 12.9 (32) 0.329 Previous application of mascara 7.3 (18) 7.3 (18) 0.0 (0) <0.001 Previous ocular surgery 10.1 (25) 6.5 (16) 3.6 (9) 0.905 Duration of illness 4 weeks 34.7 (85) 23.9 (59) 10.5 (26) Presenting visual acuity Right eye; oculus dexter Not available 2.8 (7) 2.4 (6) 0.4 (1) 0.532 FFL 12.9(32) 6.9 (17) 6.0 (15) 6/5-6/18 62.5 (155) 39.1 (97) 23.4(58) 6/24-6/60 9.7 (24) 6.9 (17) 2.8 (7) 3/60-1/60 11.7(29) 7.3 (18) 4.4 (11) Blind 0.4 (1) 0.4 (1) 0.0 (0) Left eye; oculus sinister Not available 3.2 (8) 2.8 (7) 0.4 (1) 0.112 FFL 12.9(32) 6.9 (17) 6.0 (15) 6/5-6/18 67.3 (167) 41.1(102) 26.2 (65) 6/24-6/60 6.9 (17) 6.0 (15) 0.8 (2) 3/60-1/60 9.3(23) 5.6 (14) 3.6 (9) Blind 0.4 (1) 0.4 (1) 0.0 (0) Presenting patient symptoms Eye pain 51.6 (128) 35.5 (88) 16.1 (40) 0.049 Falling Lashes 3.6 (9) 3.2 (8) 0.4 (1) 0.100 Itching 58.1 (144) 39.1 (97) 19.0 (47) 0.087 Lacrimation/Watering 52.8 (131) 33.5 (83) 19.4 (48) 0.875 Photophobia 19.0 (47) 13.3 (33) 5.6 (14) 0.249 Redness/ Hyperemia 59.3 (147) 36.3 (90) 23.0 (57) 0.509 Swelling 17.7 (44) 10.1 (25) 7.7 (19) 0.357 Whitish deposition/ discharge 45.2 (112) 26.2 (65) 19.0 (47) 0.150 Foreign body sensation 6.9 (17) 3.6 (9) 3.2 (8) 0.378 Burning sensation 6.9 (17) 5.6 (14) 1.2 (3) 0.085 Test/Investigation Visual acuity 99.6 (247) 62.9 (156) 36.7 (91) 0.192 Slit lamp Biomicroscopy 98.0 (243) 62.1 (154) 35.9 (89) 0.284 Ophthalmoscopy 98.4 (244) 62.1 (154) 36.3 (90) 0.590 Microbial analysis 95.6 (237) 60.9 (151) 34.7 (86) 0.220 Clinical signs Eyelids/lashes Healthy 95.2 (236) 59.3 (147) 35.9 (89) 0.445 Crust formation 2.0 (5) 1.2 (3) 0.8 (2) Misdirected 2.8 (7) 2.4 (6) 0.4 (1) Eyelids Healthy 57.3 (142) 35.5 (88) 21.8 (54) 0.744 Drooping 0.4 (1) 0.4 (1) 0.0 (0) Swelling 31.9 (79) 21.0 (52) 10.9 (27) Papillae 8.9 (22) 5.2 (13) 3.6 (9) Cobblestones 0.8 (2) 0.4 (1) 0.4 (1) Rashes 0.4 (1) 0.4 (1) 0.0 (0) Crust 0.4 (1) 0.0 (0) 0.4 (1) Conjunctiva Healthy 25.5(63) 15.8 (39) 9.7(24) 0.220 Injected 72.5(179) 44.9 (111) 27.5 (68) Limbal pigmentation 2.0 (5) 2.0 (5) 0.0 (0) Cornea Transparent 85.9(213) 56.5 (140) 29.4(73) 0.190 Opacified 1.6(4) 0.8 (2) 0.8 (2) Abrasions 8.5(21) 4.0 (10) 4.4 (11) Ulcers 3.6 (9) 1.6 (4) 2.0 (5) Laceration 0.4 (1) 0.0 (0) 0.4 (1) Sclera Healthy 91.5 (227) 58.9(146) 32.7 (81) 0.130 Pigmented 8.5(21) 4.0 (10) 4.4 (11) Anterior chamber Deep 97.6 (242) 62.1 (154) 35.5 (88) 0.129 Shallow 2.4 (6) 0.8 (2) 1.6 (4) Pupils Healthy (PERLLA) 97.2 (241) 62.1 (154) 35.1 (87) 0.056 Abnormal (RAPD) 2.8 (7) 0.8 (2) 2.0 (5) Iris Healthy (Dark and flat) 99.2 (246) 62.5 (155) 36.7 (91) 0.704 Prolapse 0.8 (2) 0.4 (1) 0.4 (1) Lens Transparent 79.8 (198) 48.4 (120) 31.5 (78) 0.136 Opacified 20.2 (50) 14.5 (36) 5.6 (14) Clinical presentation Blepharoconjunctivitis 4.4 (11) 2.4 (6) 2.0 (5) 0.130 Conjunctivitis 66.1 (164) 44.8 (111) 21.4 (53) Endophthalmitis 0.4 (1) 0.4 (1) 0.0 (0) Hordeolum 2.0 (5) 2.0 (5) 0.0 (0) Keratitis 8.1 (20) 3.6 (9) 4.4 (11) Keratoconjunctivitis 14.5 (36) 8.1 (20) 6.5 (15) Ophthalmia neonatorum 0.4 (1) 0.0 (0) 0.4 (1) Preseptal cellulitis 0.8 (2) 0.4 (1) 0.4 (1) Ocular trauma 2.8 (7) 1.2 (3) 1.6 (4) Uveitis 0.4 (1) 0.0 (0) 0.4 (1) Associated conditions Dry eye syndrome 23.4 (58) 18.1 (45) 5.2 (13) 0.008 Headaches 10.1 (25) 6.5 (16) 3.6 (9) 0.905 Pinguecula 2.0 (5) 1.6 (4) 0.4 (1) 0.424 Pterygium 5.6 (14) 3.6 (9) 2.0 (5) 0.912 N, frequency; %, percentage frequency Prevalence of ocular fungi in patients with presenting eye infections in Ghana Out of the 237 ocular specimens subjected to culture (owing to the inability to obtain swabs from uncooperative minor patients), 9.3% (n = 22/237) were positive for different fungal species (Please see Table 3). Of the culture-positive fungal isolates, 72.7% (n = 16/22) were C. albicans and 9.1% (n = 2/22) as Penicillium citrinum (P. citrinum). The most prevalent fungal isolates recovered from patients clinically diagnosed with conjunctivitis and keratoconjunctivitis were C. albicans (54.5 %; n = 12/22 and 9.1 %; n = 2/22 respectively). Similarly, C. albicans was frequently isolated from patients diagnosed with keratitis (4.5%; n = 1/22), and hordeolum (4.5%; n = 1/22) and with Aspergillus nomius (A. nomius) as the only fungus identified in preseptal cellulitis (4.5%; n = 1/22) as seen in Table 3 . Table 3: Prevalence of ocular fungi isolates in presenting eye infections in Ghana Type of eye infections Positive culture Negative culture A. fumigatus B. nomius C. albicans C. auris krusei Penicillium citrinum % (frequency) % (frequency) % (frequency) % (frequency) % (frequency) % (frequency) % (frequency) % (frequency) Blepharoconjunctivitis 0.0 (0) 4.6 (11) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Conjunctivitis 6.3 (15) 58.2 (138) 0.0 (0) 0.0 (0) 4.8 (12) 0.4 (1) 0.0 (0) 0.8 (2) Hordeolum 0.4 (1) 1.7 (4) 0.0 (0) 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) Keratitis 0.4 (1) 8.0 (19) 0.0 (0) 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) Keratoconjunctivitis 1.7 (4) 13.5 (32) 0.4 (1) 0.0 (0) 0.8 (2) 0.0 (0) 0.4 (1) 0.0 (0) Preseptal cellulitis 0.4 (1) 0.4 (1) 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Ophthalmia neonatorum 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Ocular trauma 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Endophthalmitis 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Uveitis 0.0 (0) 0.4 (1) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) Total 9.3 (22) 90.7 (215) 0.4 (1) 0.4 (1) 6.5 (16) 0.4 (1) 0.4 (1) 0.8 (2) n, frequency; %, percentage frequency Determinants of fungi pathogens in patients with presenting eye infections in Ghana Table 4 presents a bivariate logistic regression analysis of biographic, medical, and ophthalmic characteristics associated with prevalence of fungal ocular infections. None of the patient characteristics was significantly associated with the prevalence of fungal ocular infections as shown in Table 4 . Table 4: Bivariate analysis of factors associated with prevalence of ocular fungal infections among ophthalmic patients from Ghana Variable Bivariate regression OR 95% CI p-value Biographic and medical data Age years 1.01 0.99-1.02 0.590 Age group (years) 0-18 Ref 19-44 0.66 0.21-2.13 0.489 ≥45 1.04 0.38-2.84 0.943 Ethnicity Akan Ref Ewe 0.999 Northerner 0.999 Residence Rural Ref Urban 0.53 0.20-1.41 0.204 Religion Atheist Ref Christian 0.10 0.01-1.69 0.111 Muslim 0.06 0.00-1.71 0.098 Highest level of education None Ref Preschool 0.89 0.16-4.90 0.892 Primary 0.68 0.20-2.25 0.526 Secondary 0.61 0.19-1.95 0.408 Tertiary 0.27 0.03-2.35 0.234 Occupation Barber Ref 1.000 Beautician 1.000 Businessman/woman 1.00 1.000 Construction Worker 1.00 1.000 Dressmaking 1.000 Farming 1.000 Pastor 1.00 1.000 Student 1.000 Trading 1.000 Transport Business 1.00 1.000 Unemployed 1.000 Wage or Salary Worker 1.00 1.000 Welding 1.00 1.000 Occupation (Cat) Farmers Ref Non-farmers 0.76 0.21-2.84 0.687 Unemployed 1.96 0.42-9.09 0.392 Marital status Cohabiting Ref Divorced 0.999 Married 0.999 Single 0.999 Medical conditions Diabetes 1.55 0.33-7.38 0.579 Hypertension 1.87 0.72-4.86 0.201 Peptic ulcer 0.999 Sexually transmitted diseases 0.999 Others 0.999 Currently taking any medication No Ref Yes 2.16 0.85-5.46 0.104 Class of medications Antibiotics 0.999 Antihyertensives and antidiabetics 1.92 0.74-5.01 0.181 Antiretroviral 0.999 Antimalarial 1.000 Antiglaucoma 1.000 Herbal concoction 1.000 Ophthalmic data Eyes affected Oculus dexter Ref Oculus sinister 2.09 0.59-7.41 0.255 Oculus uterque 0.10 0.30-3.32 0.989 Part of the eye affected Eyelids/lashes 0.74 0.21-2.61 0.635 Conjunctiva 0.34 0.09-1.33 0.122 Cornea 1.04 0.33-3.23 0.953 Associated conditions Dry eye syndrome 1.89 0.75-4.75 0.179 Headaches 0.84 0.18-3.80 0.815 Pinguecula 0.999 Pterygium 0.74 0.09-5.94 0.777 Risk factors Previous eye infections 0.96 0.38-2.38 0.924 Previous use of antimicrobials 2.20 0.68-7.11 0.189 Previous use of contact lenses 1.000 Previous use of spectacles 1.15 0.43-3.08 0.787 Previous ocular trauma 0.97 0.38-2.48 0.944 Previous application of mascara 0.56 0.07-4.38 0.576 Previous ocular surgery 0.38 0.05-2.95 0.354 Duration of illness 4 weeks 1.41 0.56-3.55 0.471 Presenting patient symptoms Eye pain 0.70 0.29-1.69 0.424 Falling Lashes 0.34 0.07-1.73 0.192 Itching 1.33 0.54-3.31 0.535 Lacrimation/Watering 1.33 0.55-3.24 0.532 Photophobia 1.21 0.42-3.47 0.721 Redness/ Hyperemia 0.52 0.22-1.27 0.151 Swelling 2.32 0.88-6.10 0.088 Whitish deposition/ discharge 0.91 0.37-2.22 0.832 Foreign body sensation 1.33 0.28-6.25 0.715 Burning sensation 1.33 0.28-6.25 0.715 Bivariate regression analysis at a significance of p < 0.05. OR, odds ratio; CI, confidence interval; Ref, reference Antifungal susceptibility of recovered ocular fungi against standard antifungals, and native medicinal plants in patients with presenting eye infections in Ghana. Zones of inhibition The antifungal susceptibility was evaluated using zone inhibition and broth dilution assays. Most of the fungal isolates tested showed multidrug resistance (MDR) against standard antifungal agents with minimal zones of inhibition, and a high (>10ug/mL) minimum inhibitory concentration (MIC) and minimum fungicidal concentrations (MFC) ( Tables 5, 6, 7 ). A. fumigatus isolates were less susceptible to amphotericin B, itraconazole and fluconazole was observed whereas a greater susceptibility was seen for terbinafine. In contrast, terbinafine and itraconazole were less effective against A. nomius . The growth of C. albicans and C. auris was inhibited to varying degrees in the presence of the antifungal agents. C. krusei and P. citrinum exhibited similar reduce susceptibility to amphotericin B, itraconazole and fluconazole, but their growth was inhibited in the presence of terbinafine, as shown in Table 5 . Table 5. Zones of inhibition of standard antifungals and Ghanaian medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana Ethanolic extract (mg/ml) Mean zones of inhibition (mm) C. krusei C. albicans A. nomius C. auris P. citrinum A. fumigatus CIN 100 20.33 ± 0.58 22.11 ± 4.70 15.11 ± 1.53 22.67 ± 1.58 0 21.56 ± 2.55 50 17.00 ± 0.00 15.89 ± 3.37 11.78 ± 0.67 19.033 ± 0.33 0 18.22 ± 2.68 25 12.00 ± 0.00 12.44 ± 1.67 0 15.22 ± 0.44 0 15.22 ± 1.30 12.5 0 10.78 ± 0.97 0 0 0 10.89 ± 1.05 SYZ 100 0 16.00 ± 3.20 14.56 ± 1.24 18.89 ± 1.97 0 23.78 ± 1.09 50 0 15.00 ± 1.22 12.00 ± 1.32 16.55 ± 1.74 0 17.0 ± 1.32 25 0 13.00 ± 0.86 10.67 ± 0.5 14.56 ± 0.73 0 14.67 ± 2.78 12.5 0 10.33 ± 0.5 0 11.33 ± 0.71 0 12.56 ± 0.53 CO 100 0 0 0 0 0 0 50 0 0 0 0 0 0 25 0 0 0 0 0 0 12.5 0 0 0 0 0 0 AA 100 0 0 0 0 0 0 50 0 0 0 0 0 0 25 0 0 0 0 0 0 12.5 0 0 0 0 0 0 SA 100 0 18.11 ± 1.36 12.89 ± 0.60 0 0 17.56 ± 0.73 50 0 15.00 ± 0.71 11.33 ± 0.5 0 0 14.44 ± 0.53 25 0 13.56 ± 0.53 0 0 0 10.33 ± 0.71 12.5 0 10 ± 3.80 0 0 0 0 Standard control (µg/ml) AMB 0 0 16.11 ± 1.45 14.89 ± 1.36 0 0 TER 15.11 ± 0.6 17.56 ± 1.30 0 14.78 ± 0.83 14.78 ± 1.09 35.33 ± 1.66 ITZ 0 0 0 13.33 ± 1.80 0 0 FLZ 0 22.56 ± 2.19 19.22 ± 1.09 23.22 ± 1.09 0 0 CIN- Cinnamomum verum , SYZ- Syzygium aromaticum , CO- Chromolaena odorata , AA- Aspilia africana , SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole Phytochemicals The native medicinal plants contain secondary metabolites such as tannins, alkaloids, flavonoids, glycosides, triterpenoids, and phytosterols in majority of the extracts as shown in Table 6. Table 6: Major phytochemicals present in the extracts of Ghanaian medicinal plants. Phytoconstituent C. odorata S. alata C. verum S. aromaticum A. africana Tannins + + + + + Alkaloids + + + + + Flavonoid - + + - - Glycosides + + + - + Saponins - - - - - Triterpenoids + + + + + Phytosterols + + + - + Key: + Detected. − Not detected. Minimum inhibitory concentration (MIC) The ethanolic extracts of medicinal plant species were moderately effective (relatively high zones of inhibition Table 5 ) at different concentrations against ocular fungal isolates (MIC values ranged between 6.25–50mg/ml) as shown in Table 7 . C. krusei was sensitive to C. verum and A. africana at a concentration of 6.25 mg/ml whereas the growth of C. albicans were inhibited at a relative minimal concentration of 3.13 mg/ml. At a concentration of 6.25 mg/ml, A. nomius were susceptible to extracts of S. aromaticum whiles the growth of C. aurius and were inhibited by C. verum. P. citrinum and A. fumigatus were respectively inhibited by C. verum and A. africana at a concentration of 3.13 mg/ml as shown in Table 7 and Figure 1 . Table 7. MIC of standard antifungals and medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana Ethanolic extract (mg/ml) C. krusei C. albicans A. nomius C. auris P. citrinum A. fumigatus CIN 6.25 12.5 12.5 6.25 6.25 3.13 SYZ 12.5 3.13 3.13 25 3.13 6.25 CO 12.5 6.25 12.5 25 12.5 25 AA 6.25 12.5 12.5 12.5 25 50 SA 12.5 12.5 6.25 50 50 6.25 Standard control (µg/ml) AMB 3.91 3.91 1.95 125 3.91 31.25 TER 7.81 31.25 31.25 125 15.63 62.5 ITZ 125 62.5 62.5 125 31.25 125 FLZ 125 15.63 31.25 31.25 250 250 CIN- Cinnamomum verum , SYZ- Syzygium aromaticum , CO- Chromolaena odorata , AA- Aspilia africana , SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole Minimum fungicidal concentration (MFC) The MFC of native Ghanaian medicinal plant extracts were assayed against the recovered ocular fungi isolates using broth dilution method (Table 8). All medicinal extracts showed an equal MFCs of 25 mg/ml against C. krusei. However, relative to C. krusei , a minimal concentration of 12.5 mg/ml C. odorata, S. alata, and S. aromaticum were fungicidal to C. albicans. At a concentration of 25 mg/ml C. verum was fungicidal against both C. auris and P. citrinum with similar fungicidal effect observed for S. aromaticum on P. citrinum and A fumigatus as shown in Table 8. Table 8. MFC of standard antifungals and Ghanaian medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana Extract /MFC (mg/ml) C. krusei C. albicans A. nomius C. auris P. citrinum A. fumigatus CIN 25.00 25.00 50.00 25.00 25.00 50.00 SYZ 25.00 12.50 50.00 >100 25.00 25.00 CO 50.00 >100 >100 >100 50.00 50.00 AA 25.00 >100 >100 >100 >100 >100 SA 25.00 >100 25.00 >100 >100 50.00 Control /MFC (µg/ml) AMB 62.50 31.25 62.5 >500 >500 >500 TER 62.50 125.00 >500 >500 250.00 250.00 ITZ >500 250.00 >500 >500 250.00 >500 FLZ >500 62.50 250.00 125.00 >500 >500 CIN- Cinnamomum verum , SYZ- Syzygium aromaticum , CO- Chromolaena odorata , AA- Aspilia africana , SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole Discussion The study report on the prevalence of fungal isolates from exterior eye infections, multi-drug resistance, and explore native Ghanaian medicinal plants as source of antifungal agents. Approximately ten percent of the ocular specimens were positive for fungal pathogens with the predominant species being C. albicans . MDR was observed for common antifungal agents: fluconazole, itraconazole, and amphotericin B but not terbinafine used in the clinical treatment of oculomycosis. Ethanolic extracts of S. aromaticum and C. verum showed high fungistatic activity on most ocular fungal isolates (MIC: 31.3–12.5 mg/ml) whereas extracts of C. odorata, S. alata and S. aromaticum exhibited potent fungicidal activity against the commonest fungal pathogen C. albicans (MFC: 12.5mg/ml) implicated in ocular infections in this population. Oculomycosis is a leading cause of ocular morbidity and blindness, mostly misapprehended by ophthalmic clinicians as ocular infections of bacterial origin 32 . Such clinician misdiagnosis and mistreatment of ocular microbial infections culminate in antimicrobial resistance which is a public health concern due to negative patient outcomes (delays in healing and prolonged hospitalisation increases the financial cost of treatment and reduce the overall quality of life). The prolonged stay of patients increases the ophthalmic workload and places pressure on the limited resources of the system 33,34 . In this regard, microbial and/or laboratory investigations of clinically presented oculomycosis have a considerable impact on accurate diagnosis and administration of therapeutically effective antifungal therapy with a concurrent impact of improving clinical prognosis and decreasing complications 35,36,37 . The burden and etiology of ocular mycosis vary across regions and settings and changes over time thereby necessitating regional-specific estimates, characterisation of ocular fungal isolates and elucidation of efficacy of antifungal therapy to provide reference information for eyecare providers. Given the evidence gap in Ghana, we present preliminary data on the burden and etiology of ocular fungal infections and antifungal susceptibility of clinically used antifungal agents for treating oculomycosis in Ghana. The prevalence of eye infections of fungal etiology in this study was approximately ten percent. Globally, the burden of oculomycosis across different populations, geographical regions, and settings show no consensus patterns with prevalence estimates ranging from 0.05 to 97.0% 4,38,39 . A systematic review and meta-analysis by Phongkhun et al . that estimated pooled prevalence of ocular candidiasis and endophthalmitis range between 7.4–10.7% 5 . In a 6-year hospital-based study in Northern India, Chander and Sharma revealed a 7.26% positive fungal culture among ophthalmic patients with corneal ulcers 40 . Kowalski and colleagues in a retrospective laboratory review showed a proportion of fungal pathogens implicated in cases of infectious keratitis was estimated at 6.7% 41 . Our estimates are relatively low, about two to five times lower compared to results from India 38 , Paraguay 42 , and China 43 . In this study, we identified C. albicans as the predominant fungal species implicated in ocular mycoses among ophthalmic patients from Ghana. The findings are consistent with studies in the United States 39 , United Kingdom 4445 , and Japan 46 , but contrast with results from Northern India 40,47 , China 43 , and Brazil 48 , Ethiopia 49 , that identified Aspergillus spp . and Fusarium spp as the predominant cause of oculomycosis 40,43,47,48,49 . The observed increased proportion of opportunistic yeast-like fungi, C. albicans as opposed to filamentous fungi could be ascribed to patient characteristics (female sex and immunocompromised ailments and immunosuppressants) and high virulence factor of host pathogen 50,51,52 . The study showed multi-drug resistance of commonly used antifungal agents (amphotericin B fluconazole, itraconazole) on clinically recovered ocular fungal isolates from ophthalmic patients. The observed resistance of A. fumigatus to fluconazole and itraconazole are consistent with remarkable trends of secondary azole resistance in these species whiles their concurrent superbug effects towards amphotericin B could ascribed to primary antifungal resistance mechanism 53,54,55,56 . As expected, A. nomius showed azole resistance to itraconazole 53 . However, its resistance to terbinafine was worrying given that terbinafine is a clinically valid therapeutic surrogate to itraconazole owing to better clinical efficacy, safety and low cost 57 . Although C. albicans and C. auris showed susceptibility to all antifungal agents used in this work, the considerable reduce zone of inhibition of C. albicans in the presence of amphotericin or itraconazole as opposed to terbinafine and fluconazole underscores the need for antimicrobial surveillance to monitor potential drug-resistance. The observed resistance of Candida krusei and P. citrinum to amphotericin B may be ascribed to altered genetic makeup of clinical isolates owing to its broad-spectrum clinical application/treatment 58 . Whiles the increased resistance of the above mentioned ocular isolates to azoles could be due to genetically resistance biofilms and efflux pumps activated to withstand high concentrations of these antifungal agents 52,59,60 . The medicinal extracts, Syzygium aromaticum and Cinnamomum verum , demonstrated potent fungistatic activity against the clinically recovered fungal isolates including, C. albicans , commonly implicated in oculomycosis in this ophthalmic population. The findings are consistent with previous reports of the plants antifungal effect 29,61,62,63 . Essid et al. shows excellent anti-Candida activity of essential oils of C. verum with MIC values ranging from 31.25 to 62.5 µg/ml and moderate anti-Candida activity of S. aromaticum with MIC values 125 and 250 µg/ml 29 . Oresins and essential oils of S. aromaticum have shown to exhibit antifungal activity against C. albicans at significantly lower MIC values than antifungal agents 62 . The observed relatively high MIC could be explained by our exploration of crude plant extracts that contain a wide spectrum of unrefined phytochemicals that could mask the bioactivity other than essential oils that contain volatile aromatic compounds 64 . Our extracts showed fungicidal activity against ocular fungal isolates which corroborates with previous reports 65 . The results illuminate native medicinal plants as excellent source of antifungal agents that necessitates its optimization. The study presents the first comprehensive estimates of the prevalence and antifungal susceptibility profile of ocular fungal isolates among patients with presenting eye infections in Ghana and illuminate native medicinal plants with antifungal activity. The results are critical to optimize the eye health, and broadly inform institutional planning and actualizations of surveillance programs to monitor and curtail emerging multi-drug resistance. Despite the promising results of the phytochemical screening, the study was limited by the inability to isolate the bioactive compound responsible for the antifungal activity, and therefore, ophthalmic patients are strongly advised to desist from using native plants to treat oculomycosis. Although the study shed insights on the state of standard antifungal against clinically recovered ocular fungal isolates in patients, yet it is limited by the inability to evaluate commonly used ocular antifungals such as natamycin and voriconazole due to their inaccessibility. We recommend future studies evaluate the abovementioned antifungals and importantly expand the range of fungal strains beyond the ones recovered from infectious eyes in this study to enhance the overall clinical utility of the plant extracts. Given the logistic constraints, authors did not sequence the ocular fungal isolates, nonetheless, the combination of culture and PCR techniques provides robust sensitivity and specificity for fungi identification and characterization 66 . Conclusion The proportion of positive fungal cultures in ocular infections was approximately ten percent, with C. albicans identified as the predominant etiology. Clinical antifungal agents: amphotericin B, terbinafine, itraconazole, and fluconazole were found to be ineffective (minimal zone of inhibition, high MIC and MFCs) against the clinically recovered ocular fungal strains. The in vitro antifungal assays of the medicinal extracts showed antifungal activity which bespeaks its potential antifungal therapeutic prospects. Taken together, the evidence shown augments the current understanding on the epidemiology of oculomycosis and expands the horizon of showcasing novel source for bioprospecting lead compounds of potential clinical translation. . Materials and Methods Study Design The multicenter, cross-sectional study was conducted from May 9, 2023, to June 15, 2023, among ophthalmic patients with suspected ocular infections of fungal etiology at three health facilities in Ghana: Anglican Eye Hospital, Jachie; St. Michaels Hospital, Pramso; and Kumasi South Hospital, Agogo. Patients' biographical and clinical data were collected using a structured questionnaire. Ocular specimens, specifically conjunctival swabs and corneal scrapings were examined for fungal pathogens. Antifungal susceptibility testing was performed using clinically used standard antifungal agents and native medicinal plants being investigated as potential antifungal agents. Study population The study population consisted of patients who sought ophthalmic care/services for exterior eye infections at the Anglican Eye Hospital, Jachie; St. Michaels Hospital, Pramso; and Kumasi South Hospital from May 9 to June 15, 2023. Following informed consent (and written parental consent for minors), a purposive sampling strategy was used to enroll all patients presenting with signs and symptoms of external ocular infections. Patients presenting solely for optical correction, receiving systemic/topical antibiotics, or with one week history of ocular surgery were excluded. Study setting The Anglican Eye Hospital, St. Michael's Hospital, and Kumasi South Hospital were selected for this study because of their high outpatient department (O.P.D.) utilization, large catchment area, and rural-urban interactions. The Anglican Eye Hospital and St. Michael's Hospital are in Bosomtwe, a rural district in Ghana, while Kumasi South Hospital is in the Asokwa Municipality, an urban settlement in the Ashanti Region of Ghana. All three facilities have either a permanent or visiting ophthalmologist, optometrists, ophthalmic nurses and opticians. They provide comprehensive eye care services, including medical history, visual acuity assessment, refraction, dispensing of refractive glasses, management of anterior and posterior segment pathologies, prescription of medications, and performance of scheduled surgeries. St. Michael's Hospital and Kumasi South Hospital serve as immediate referral hospitals for the surrounding private and polyclinics. However, all clinical emergencies are referred to the Komfo Anokye Teaching Hospital, the only tertiary health facility in the region. The study facilities do not have a microbiology laboratory, so clinicians rely on empirical approaches for routine diagnosis and management of external ocular and periocular infections. Study variables Operation definition Blepharitis was characterized by symptoms such as gritty, itchy, and sore eyes with crusting and/or collarettes around the base of the eyelashes, as well as clogging of the meibomian gland and loss of eyelashes. Conjunctivitis was defined by conjunctival lesions with symptoms including hyperemia, chemosis, purulent discharge, and hemorrhage. Blepharoconjunctivitis presented with redness, dry and scaly eyelids, and symptoms of itchiness and burning. Keratoconjunctivitis was associated with complaints of dryness, itching, and mucous discharge in both the cornea and conjunctiva. Keratitis was characterized by corneal lesions with symptoms such as edema, cellular infiltration, pain, redness, and photophobia. Hordeolum was defined as swelling and tenderness of the eyelid with acute pain, photophobia, and mild epiphora. Ophthalmia neonatorum is a type of neonatal conjunctivitis that occurs within the first 28 days of life and is characterized by signs such as eyelid edema, erythema, and purulent discharge. Preseptal and orbital cellulitis showed similar features of painful swelling and/or tenderness of the eyelid with the later distinguished from the former by decreased vision and pain on eye motility 14 . Data collection Biographic and clinical data The patients sociodemographic, socioeconomic, and health status variables were gathered by the principal investigator and a trained research assistant using a structured questionnaire. A comprehensive vision assessment including visual acuity, slit lamp bio microscopy, and ophthalmoscopy was performed by a registered optometrist on all study participants. Subsequently, patient medical history, primary and secondary diagnosis, and antimicrobial therapy prescribed were extracted using a data collection form. Specimen collection and transport A total of 237 ocular samples were collected from patients with external eye infections utilizing aseptic procedures. To obtain the conjunctival samples, the patients' eyes were positioned upward, and the lower tarsal plate of the eyelids and the fornix of the conjunctiva were gently rolled with a moistened saline cotton bud in repeated strokes from nasal to temporal and vice versa. For corneal ulcer and keratitis infections, a modified version of an earlier protocol was employed, which involved utilizing slit-lamp biomicroscopy and topical local anesthesia (1-2 drops of 0.5% fresh proparacaine) to firmly scrape the edges of the ulcer. However, no patients in the study had dacryocystitis and/or blepharitis, thus puncture and/or aspiration of the lacrimal sac and swabbing of the eyelids were not performed. The samples were then placed in a sterile, freshly prepared nutrient broth and transported within 1-3 hours in a standard triple packaging system (an absorbent cotton wrapping primary container enclosed in a sealed bag and kept in an insulated icebox with icepacks) from the study sites to the Faculty of Pharmacy and Pharmaceutical Sciences Laboratory at the Kwame Nkrumah University of Science and Technology for fungal microbial investigation. Laboratory methods Characterization of fungal ocular isolates Ocular specimen was investigated for fungal pathogens using standard microbiology techniques. Briefly, ocular specimens were inoculated on a potato dextrose agar ( Oxoid Ltd. Basingstoke, Hants United Kingdom ) and incubated at 37°C for 96 hours. Fungal positive culture was primarily confirmed by sub-culturing on Potato Dextrose Agar (PDA) supplemented with 100 µg/ml streptomycin, and 100µg/ml penicillin (Fisher Scientific, Schwerte, Germany). Morphologic characterisation, and microscopic identification were performed as seen in Table 9 . Table 9: Identification and characterisation of clinically recovered ocular fungal isolates among ophthalmic patients from Ghana. Isolate code Colony characteristics Microscopic characteristics Isolate name KS1 Deep cream color, round shape, pasty and smooth texture with a smell Pseudo-hyphae with terminal chlamydospores; clusters of blastoconidia at septa Candida albicans 4 Cream color, round, and smooth surface Clusters of small, budding, ovoid, and elongated cells. No pseudo-hyphae. Candida auris SM14 Bluish-green color with a white border, powdery surface, and reverse color is yellow Septate hyphae with conidiophores and metulae forming flask-shaped phialides bearing round conidia (“brush” appearance) Penicillium citrinum SM22 Cream color, round shape, pasty, and smooth surface Round and oval cells parallel to pseudo-hyphae (appearance of logs) Candida albicans AE5 Green color with a white border, and smooth surface, and the reverse color is white Septate hyphae, with smooth and short conidiophores and an equal length of biseriate phialides and metulae forming the upper half of the vesicle. Aspergillus nomius K1 Cream color with rough, mycelial fringe (wrinkle) surface Oval and elongated cells Candida krusei KS3 Bluish-green color with a powdery or velvety surface and the reverse color is white. Septate hyphae, smooth and short conidiophores. Compact uniseriate phialides (occupies upper two-thirds of the vesicle) Aspergillus fumigatus DNA extraction and quantification Ocular fungal genomic DNA was extracted using the Quick-DNATM Fungal/Bacterial MiniPrep Kit (Zymo Research Group, California, USA) according to the manufacturer's instructions. The quality of the extracted DNA was evaluated by agarose gel electrophoresis. The concentration of isolated DNA was determined using a Nanodrop ND 2000 at 260 nm (Thermo Scientific, USA). Polymerase chain reaction The fungal internal transcribed spacer region (ITS1-5.8S rDNA-ITS2) and the D1/D2 domain of the 26S rRNA gene were amplified from genomic DNA isolated from ocular fungal samples using PCR ITS1 and ITS4 (Forward[F]d: ITS1'-5' TCCGTAGGTGAACCTGCG G3' and reverse[R]: ITS4-5'- TCCTCC GCTTATTGATATGC3') and NL-1 and NL-4 (F: NL1- 5'-GCA TATCAATAAGCG GAGGAAAAG and R: NL4- 5'- GGTCCGTGTTTCAAGACGG) primer pairs (New England BioLabs Inc). PCR reactions were performed in a 20 µL reaction volume. Briefly, 1 µL of template DNA was added to a 19 µL master mix containing 12.5 µL of 10x Dream TaqTM Green Buffer (KCl, [NH4]2SO4 and 20 mM MgCl2), 0.5 µL each of forward and reverse primers, and 5.5 µL nuclease-free water. The denaturation step was performed at 95˚C for 5 minutes, followed by 25 amplification cycles of 95°C for 1 minute, 49°C (ITS1-F and ITS4-R) or 52°C (NL1-F and NL4-R) for 30 seconds, and 72°C for 2 minutes, with a final extension step of 10 minutes at 72°C. PCR products were examined on 1.5% agarose gels run in 1 x Tris-borate-EDTA (TBE) buffer and visualized by ethidium bromide staining under UV light. Antifungal susceptibility testing Antifungal susceptibility testing was performed using the agar well diffusion method, as previously documented 67 , 68 , for common clinically used antifungal agents and medicinal plant extracts. To commence the procedure, a microbial inoculum of isolated ocular fungi with a McFarland standard of 0.5 (1x10 7 CFU/mL) was employed to create an even lawn of cells on a 20mm sterile plate with potato dextrose agar. Subsequently, equal diameter wells (6mm) were created using a sterile cork-borer, and each well was respectively seeded with 0.1ml of crude medicinal plant extracts of four different concentrations (100, 50, 25, 12.5 mg/ml). Clinical antifungal agents used as reference drugs were prepared by dissolving in DMSO (amphotericin B [AMB], terbinafine [TER], itraconazole [ITZ]) and distilled water (fluconazole [FLZ]) 31 . Following incubation, the clear zones around the wells containing extracts and anti-fungal drugs (zone of inhibition) were measured in millimeters using a caliper and meter rule. The entire procedure was performed in triplicates to obtain the mean zone of growth inhibition. DMSO was and distilled water were tested as negative controls 67 , 68 . Determination of Minimum Inhibitory Concentration and Minimum Fungicidal Concentration The minimum inhibitory concentration (MIC) of crude medicinal plant extracts were evaluated using the broth dilution assay as previously described 67 , 69 , 70 . Two-fold serial dilutions of the extracts or standard antifungal agents (AMB, FLZ, ITZ, and TER) were prepared in sterile 96-well microtiter plates. One hundred microliters of each two-fold serial dilution of crude extract were transferred into the wells, followed by the addition of 100 μl of double strength nutrient broth containing an inoculum size of approximately 2.0 x 10 5 CFU/ml. The plates were incubated for 24 hours at 37°C. Afterward, 20 µL of a 1.25 mg/mL 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (M.T.T) solution were added to each well, and the plates were further incubated for 30 minutes at 37°C. The MIC was determined as the lowest concentration of extract or antibiotic that completely inhibited the growth of the organism in the microdilution wells, as detected by the absence of purple coloration after MTT addition during a 24-hour incubation period at 37°C. All assays were performed in triplicate. Furthermore, the minimum fungicidal concentration (M.F.C) was performed as previously described 69 . For each well that displayed no obvious purple coloration indicative of growth from the MIC assay, 20 µL of suspension was transferred into new plates containing 100 µL freshly prepared nutrient broth. The microtiter plates were then incubated at 37°C for 24 hours. Following the incubation period, 25 µL of 125 mg/mL MTT was introduced into each well and incubated at 37°C for 30 minutes to facilitate the proliferation of microorganisms. MFC was defined as concentration at which no visible growth was observed after the introduction of the MTT dye 67 , 69 , 70 . Collection, authentication, and preparation of medicinal plants The fresh leaves of S. alata, C. odorata, and Aspilia africana were collected from Kwahu-Asakraka (6°38′05.2″N 0°41′20.6″W) in the Eastern Region of Ghana between June and July 2023. Similarly, dried flower buds of S. aromaticum and powdered stem bark of C. verum were purchased from a spice retail shop from a local market in the Ashanti Region of Ghana (latitude 6.6886 o N, longitude 1.6156 o W), in the Ashanti region of Ghana in July 2023. The authentication of the medicinal plants was performed by an expert botanist and the herbarium accession number of the S. alata ( KNUST/HMI/2023 L016), A. africana ( KNUST/HMI/2023 L017), C. odorata ( KNUST/HMI/2023 L018) C. verum (KNUST/HMI/2023 SB027) and S. aromaticum (KNUST/HMI/2023 FB001) respectively stored at the reference repository of the Department of Herbal Medicine at the Kwame Nkrumah University of Science and Technology in Kumasi, Ghana. After collection, the fresh leaves of S. alata , C. odorata , and A. africana were washed under running tap water and left to air-dry at room temperature for six days to remove moisture. The dried leaves and dried flower buds of S. aromaticum and C. verum were homogenized into a fine powder and stored in an airtight plastic container at room temperature until use. Extraction and phytochemical analysis of plants Ethanolic extracts of medicinal plants were obtained using cold maceration method as previously documented. Phytochemical screening performed on plant extracts to identify bioactive compounds as described previously 66,67, 71 , . Briefly, to elucidate the presence of tannins, a 100 mg sample of each plant extract was mixed with 3 ml of distilled water and 2 drops of 10% alcoholic FeCl 3 solution. The formation of a deep blue or green coloration signified the presence of tannins. For saponins, a 100 mg of plant extract was mixed with 3 ml of distilled water, resulting in persistent foam formation as a marker of saponins. To test for alkaloids, a 100 mg sample extract was mixed with 3 ml of distilled water and vigorously shaken. A 1 ml sample of each solvent extract was then treated with 4 drops of 1% HCl, heated at 60°C for 60 seconds, and cooled. Next, 5 drops of Wagner's reagent were added to the solution, and the formation of a reddish-brown precipitate indicated the presence of alkaloids. To test for terpenoids, A mass of 100 mg of each of the plant extract was added to three (3) mL of distilled water and mixed vigorously. A volume of 0.5 mL of chloroform was added to one (1) mL of the solvent extracts in different test tubes and treated with two (2) drops of concentrated H 2 SO 4 slowly down the test tube wall. A ring formation of reddish-brown precipitate showed the occurrence of terpenoids. To test for flavonoids, a mass of 100 mg of each of the plant extract was added to three (3) mL of distilled water and mixed vigorously. One (1) mL of each solvent extract was treated in their separate test tubes with a few drops of 20% NaOH. The presence of flavonoids was demonstrated by the production of a bright yellow color that became colorless with the addition of dilute HCl. Liebermann’s test was performed to ascertain the presence of glycosides. Briefly, crude extract was combined with equal volumes of chloroform and acetic acid (2ml), and the resulting mixture was cooled in an ice bath and cautiously added with concentrated sulfuric acid. The presence of a color change from violet to blue to green indicated the presence of glycoside 66, 68 ,70 . Quality assurance and control The study used a modified structured questionnaire to collect demographic and clinical data. Questionnaires were written in English and administered by the principal investigator and a trained research assistant. The questionnaire was explained in the local dialect for study participants who could not understand instructions in English. Study data were double-checked for accuracy and completeness. At the facility, all test tubes containing eye samples were well labeled to prevent mix-ups. Laboratory reagents and culture media for the experiments were checked for expiration dates, and sterility control was performed to determine the integrity of the media, such as freedom from contamination. Evaluation of media performance and/or functionality was performed using the American Type Culture Collection (A.T.C.C.) standard reference strains of C. albicans ATCC 10231. Medicinal plant species used for studies were accurately identified and verified by an experienced botanist. Data protection and management The hardcopy of the completed questionnaires was securely stored in a locked location, accessible only to the principal investigator and research consultant. Similarly, the non-aggregated data set in softcopy was protected by a strong alphanumeric password. The research report presented to institutions and for publication was aggregated, making it impossible to trace individual study participants. Ethical considerations A hierarchical ethical review protocol was followed to conduct this study. The study protocol was modified from a previous investigation and approved by the Committee on Human Research, Publication and Ethics (C.H.R.P.E.) of the Kwame Nkrumah University of Science and Technology and the Komfo Anokye Teaching Hospital (reference number: CHRPE/AP/116/24). Written informed consent was obtained from all adult participants. For minors, written informed consent was obtained from caregivers after the study protocol was explained to the best of their understanding. The study adhered to the tenets of the Declaration of Helsinki, and all laboratory procedures were performed in accordance with the guidelines of the Clinical Laboratory Standard Institute (C.L.S.I.). Statistical analysis Data were entered and processed in Microsoft Excel before being exported to a Windows-compatible version of a statistical package and service solution (IBM Corporation IBM® SPSS® Statistics for Windows, version 25.0 Armonk, NY). The Kolmogorov-Smirnov statistic was used to determine normality. Biographical, medical, and ophthalmic characteristics were presented, and the sex difference was examined using chi-squared analysis. Cross-tabulations with frequencies and percentages were used to illustrate clinical diagnosis, cultural status, and antifungal therapy. All antifungal susceptibility assays were performed in triplicate with identical colonies, and inhibition zones are presented as mean ± standard deviation. The association between sample characteristics and the prevalence of ocular fungal infections was examined using bivariate logistic regression with a significance level of p <0.05. Abbreviations A.E.H.: Anglican Eye Hospital, A.M.R.: Antimicrobial Resistance, M.D.R.: Multidrug-Resistance C.H.A.G.: Christian Health Association of Ghana, C.H.R.P.E.: Committee on Human Research Publication and Ethics, C.L.S.I.: Clinical Laboratory Standard Institute Guidelines, R, resistant; S.D.: Standard Deviation, M.I.C.: Minimum Inhibitory Concentration, M.F.C.: Minimum Fungicidal Concentration, A.M.B. B.: Amphotericin B, T.E.R.: Terbinafine, I.T.Z.: Itraconazole, F.L.Z.: Fluconazole, M.T.T.: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Declarations Acknowledgement The authors would like to express their sincere gratitude to the authorities and staff of the Anglican Eye Hospital, St. Michaels Hospital, and Kumasi South Hospital for allowing the study to be conducted and to the study participants for their willingness to participate. We gratefully acknowledge the support of the Faculty of Pharmacy and Pharmaceutical Sciences, the Department of Theoretical and Applied Biology, and the Department of Optometry and Visual Sciences all at K.N.U.S.T for the use of their resources and facilities for the study. Special thanks to Dr. Vivian Boamah (Department of Pharmacology, K.N.U.S.T., Kumasi, Ghana), Mr. Clifford Asare (Department of Herbal Medicine, Faculty of Pharmacy and Pharmaceutical Sciences, K. N.U.S.T., Kumasi, Ghana), Mrs. Millicent Ogyiri and Mr. Bismark Ofori (Department of Microbiology, Faculty of Pharmacy and Pharmaceutical Sciences, K.N.U.S.T., Kumasi, Ghana) for their technical assistance. Authors’ contribution A.O.B. and I.O.D.J contributed equally to the work. A.O.B.: project administration; methodology; investigation; software; formal analysis; writing-review and editing. I.O.D.J.: project administration, conceptualization, experimental design, methodology, data curation; visualization; software; formal analysis; resources; writing original draft; writing–review and editing; L.G.: methodology, investigation, writing- reviews and editing. K.O.A.: resources, experimental design, methodology, writing-review and editing. K.B.: project administration; conceptualization; experimental design; methodology; data curation; resources; writing-review and editing, supervision. All authors have read and approved the manuscript. Funding The study was supported in part by a Sigma Xi Grant in Aid for Research from the Scientific Research Honor Society (Grant ID: G2022315-2372) to Dr. Carolyn Yanney. Availability of data materials All relevant data and materials supporting the conclusion of this article is/are available within the manuscript and its supporting information files. The corresponding author can be contacted for any other additional information required. Ethical consideration To conduct this study, a hierarchical ethical consideration protocol was followed. Written permission was obtained from the authorities of the Anglican Eye Clinic, St. Michaels Hospital and Kumasi South Hospital The study protocol was modified from a previous investigation and approved by the Committee on Human Research, Publication, and Ethics (C.H.R.P.E.), of Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital (reference number: CHRPE/AP/116/24). Written informed consent was obtained from all adult participants. For minors, written informed consent was obtained from caregivers after the study protocol was explained to the best of their comprehension. The study adhered to the tenets of the Declaration of Helsinki, and all laboratory procedures were performed in accordance with the Clinical Laboratory Standard Institute (C.L.S.I) guidelines. Conflict of interest The authors declare no competing interests. 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In vitro fungicidal activities of voriconazole, itraconazole, and amphotericin B against opportunistic moniliaceous and dematiaceous fungi. Journal of clinical microbiology 39 , 954–958 (2001). Yadav, R. & Agarwala, M. Phytochemical analysis of some medicinal plants. Journal of phytology 3 , (2011). Additional Declarations There is NO Competing Interest. Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4656890","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":321215839,"identity":"5efb1c34-6482-4d96-8c1a-d46fbb2911c7","order_by":0,"name":"Kingsley 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\u003cem\u003eSenna alata \u003c/em\u003ev \u003cem\u003eCandida albicans\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eE.\u003cem\u003eCinnamomum verum\u003c/em\u003e v \u003cem\u003eAspergillus fumigatus\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4656890/v1/9df16346b763ea0d899a5ee1.png"},{"id":62655173,"identity":"6c2bbdd2-895b-481e-a617-56e884382455","added_by":"auto","created_at":"2024-08-17 01:33:05","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":330248,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCultural pictures of clinically recovered ocular fungal isolates among ophthalmic patients from Ghana. \u003c/strong\u003eA= Candida spp, B= Candida krusei, C= Aspergillus nomius, D= Candida auris, E= Penicillium citrinum F= Aspergillus fumigatus, G= Candida spp.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4656890/v1/9b192f24dfb3a9856ff4c7cb.png"},{"id":62655174,"identity":"02813045-974d-41a4-93fe-9713cd9bc1b3","added_by":"auto","created_at":"2024-08-17 01:33:06","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":434116,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMicroscopic pictures of clinically recovered ocular fungal isolates among ophthalmic patients from Ghana.\u003c/strong\u003e A= Candida krusei, B= Candida spp, C= Candida auris, D= Aspergillus fumigatus E= Aspergillus nomius F= Penicillium citrinum.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4656890/v1/6134fbf6442d89f7f12fb449.png"},{"id":62655623,"identity":"5e22ea1f-3997-4128-b6bc-bf9829f02974","added_by":"auto","created_at":"2024-08-17 01:41:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4008471,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4656890/v1/238a1203-7bd7-4f11-8bef-08b0ca617a1c.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e Competing Interest.","formattedTitle":"Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy","fulltext":[{"header":"Background","content":"\u003cp\u003eFungal eye infections or oculomycosis, are caused by various species of fungi that can affect different parts of the eye, such as the conjunctiva, cornea, eye lids, as well as the interior of the eye; clinically termed mycotic conjunctivitis, keratitis, blepharitis, and endophthalmitis. Although relatively rare, mycotic eye infections can cause significant morbidity and vision loss.\u003csup\u003e1\u003c/sup\u003eUnlike bacterial eye infections, epidemiologic estimates of fungal eye infections are limited due to the diagnostic challenges. However, recent studies estimate the annual incidence of keratomycoses to be 1,051,787 cases per year, with the highest burden recorded in Asia and Africa regions\u003csup\u003e2,3\u003c/sup\u003e. The burden of ocular mycoses varies by geographic region, populations, seasonal variations, and innate predisposing factors \u003csup\u003e4,5\u003c/sup\u003e. In particular, the burden remains high in tropical and subtropical regions owing to suitable high humidity for spore growth, and increase exposure to vegetative matter \u003csup\u003e6,7,8\u003c/sup\u003e. Other intrinsic (impaired immunity resulting in cancer, HIV/AIDS and diabetes), and extrinsic (contaminated contact lens, ocular trauma or surgery, use of topical steroids, and antibacterials) \u003csup\u003e8 ,9\u003c/sup\u003e factors increase the likelihood of fungal eye infections. The prevalence of fungi pathogens implicated in presenting eye infections in Ghana remains unknown.\u003c/p\u003e \u003cp\u003eA staggering number of fungal pathogens have been implicated in oculomycosis, with an increase in incidence due to seasonal variations\u003csup\u003e9\u003c/sup\u003e. While filamentous fungi (Fusarium, Aspergillus, Acremonium, and Penicillium species) remains the cause of oculomycosis in tropical and subtropical regions, yeast and yeast-like fungi (Candida, Cryptococcus, and Malassezia species) assumes a significant etiology in temperate regions.\u003csup\u003e8,9,10\u003c/sup\u003e. Clinically, patients with ocular mycoses present with symptoms of ocular pain, redness, lacrimation, watery to thick mucus discharge, photophobia, and decreased visual acuity, which are usually misinterpreted by ophthalmologists as bacterial infections. Such clinical misdiagnosis of suspected external ocular and periocular infections of fungal etiology may exacerbate into corneal perforation and consequently compromise the middle and inner tunics of the eye, resulting in panuveitis, endophthalmitis, or even loss of the eye.\u003csup\u003e7,11\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe duration of treatment for ocular fungal infections varies depending on the fungus involved and the severity of the disease\u003csup\u003e12\u003c/sup\u003e. Such a disease prognosis emphasizes accurate diagnosis and timely initiation of ophthalmic treatment. However, in resource-limited settings such as Ghana, due to the lack of rapid molecular diagnostics and high-throughput screening facilities, consulting eye care providers are accustomed to observing clinical features as the basis for diagnosis and management of oculomycosis. Specifically, eye care providers perform a comprehensive patient history to collect patient symptoms, and gross ophthalmic assessments using slit lamp biomicroscopy, ophthalmoscopy, and visual acuity to identify peculiar clinical signs and apply broad-spectrum antimicrobial therapy. \u003csup\u003e13,14,15\u003c/sup\u003e. To date the fungi pathogens involved in eye infections among patients in Ghana is lacking.\u003c/p\u003e \u003cp\u003eFurthermore, the routine method of clinical diagnosis is not only flawed by the inability to determine the causal etiology, but also perpetuates multi-drug resistance (MDR) due to the increase patronization of broad-spectrum antimicrobials\u003csup\u003e16\u003c/sup\u003e. MDR has receives a significant attention in developed countries with implementation of various initiatives \u003csup\u003e17,18,19,20\u003c/sup\u003e. However, such effort is limited in resource constraint settings such as Ghana where there is poor regulatory compliance and adherence to antimicrobial handling and use, and limited accessibility of national antimicrobial policy guidelines\u003csup\u003e21\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOf note, antifungal agents such as polyenes (natamycin, nystatin, and amphotericin B), allylamines (terbinafine), azoles (fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and echinocandins classes are utilize in the management of fungi infections including ocular mycosis\u003csup\u003e22\u003c/sup\u003e. Echinocandins, the polyenes, allylamines, and azole class of antifungal medications are readily available and commonly used by medical and eye care providers in Ghana\u003csup\u003e23,24,25\u003c/sup\u003e. Current trends in medicine and public health show increasing AMR and MDR to clinically used antimicrobial agents such as antifungals. However, there remains a paucity of evidence on the antifungal susceptibility status of commonly administered antifungal drugs used by ophthalmic clinicians in Ghana.\u003c/p\u003e \u003cp\u003eNatural products represent a significant source of phytoconstituents with a promising propensity for development into novel drug therapies\u003csup\u003e26\u003c/sup\u003e. As a semi-arid region, Ghana is home to an array of medicinal plants traditionally utilized to treat various infections owing to their beneficial phytochemicals such as alkaloids, flavonoids, tannins, glycosides, saponins, triterpenoids, and phytosterols\u003csup\u003e27,28\u003c/sup\u003e. The vegetative parts of plants such as \u003cem\u003eAspilia Africana (A. Africana), Chromolaena odorata (C. odorata), C. verum, S. aromaticum, Senna alata (S. alata)\u003c/em\u003e are known for their antifungal activity\u003csup\u003e29,30\u003c/sup\u003e. However, the fungistatic and fungicidal potential of these medicinal plants against ocular microbes have not been previously studied. Our preliminary elucidation of the antifungal potential of these medicinal plants against ocular fungal isolates could gauge the bioprospecting of bioactive lead compounds with potential for clinical development into novel treatment therapy for oculomycosis.\u003c/p\u003e \u003cp\u003eTherefore, the primary objective of this study elucidates the fungal pathogens implicated in clinically presenting eye infections and ascertain the antifungal susceptibility of antifungal agents commonly used by clinicians to manage oculomycosis in Ghana. Additionally, the study explore five different Ghanaian medicinal plants as potential source for leads bioactive compounds for treating oculomycosis. Altogether, the primary outcome of our study provides regional specific estimates on the prevalence and commonly implicated fungi pathogen in ocular infections and importantly guide ophthalmic clinicians on their choice of antifungal agents to clinically manage oculomycosis. To this end, the completion of the secondary aim remains essential to inform translational studies in the discovery of novel effective antifungal therapies for oculomycosis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eBiographic and medical data of patients presenting with eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 presents biographic and medical data of the patients enrolled in the study. \u0026nbsp;Of the 248 patients with presenting exterior eye infections, majority were females (62.9%), of median age of 30.50 (Interquartile range; 43.75) years. Most of the patients were aged between 0-18 years (35.9%), of Akan ethnicity (90.7%), rural residence (59.7%), adhere to the Christian religion (91.5%), and possess a secondary highest level of education (33.5%). There was a significant variation in males and females in terms of occupation (p \u0026lt; 0.001), with most patients\u0026rsquo; occupation category being non-farmers (74.6%) and with a single marital status (56.9%). Of the medical conditions, a significantly higher female compared to males were having hypertension (15.7% versus 4.4%, p = 0.013), currently on medications (21.8%) and with a significantly higher female on anti-hypertensive/antidiabetic class of medications compared to their male counterparts (15.7% versus 4.0%, p = 0.007) as shown in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"736\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"68.79240162822252%\" colspan=\"5\" valign=\"bottom\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1: Biographic and medical data of study participants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003eTotal (N = 248)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003eFemales (N=156, 62.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003eMales (N=92, 37.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003eBiographic characteristics\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e0-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e35.9 (89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e15.7 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e19-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e29.4 (73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e9.3 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e34.7 (86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e22.6 (56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e12.1 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eAkan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e90.7 (225)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e58.1 (144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e32.7 (81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.458\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eEwe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eNortherner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e59.7 (148)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e39.5 (98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e40.3 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e23.4 (58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e16.9 (42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eAtheist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e91.50 (227)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e56.5 (140)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e35.1 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e7.7 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest level of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e20.6 (51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e14.5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003ePreschool\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e5.2 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e26.2 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e17.3 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e33.5 (83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e19.8 (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e13.7 (34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e10.9 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.8 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eBarber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eBeautician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e3.2 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eBusinessman/woman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eConstruction Worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eDressmaking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eFarming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e12.1 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003ePastor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e33.1 (82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e19.8 (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e13.3 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eTrading\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e14.9 (37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e12.5 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eTransport Business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e13.3 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eWage or Salary Worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e10.9 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e6.5 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eWelding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation (Cat)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eFarmers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e12.1 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.774\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eNon-farmers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e74.6 (185)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e46.0 (114)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e28.6 (71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e13.3 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eCohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e14.5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e11.7 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e26.6 (66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e15.7 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e10.9 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e56.9 (141)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e34.7 (86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e22.2 (55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cem\u003eMedical characteristics\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e5.2 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e15.7 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003ePeptic ulcer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.8 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eSexually transmitted diseases\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e0.0 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.265\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.81139755766621%\" colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrently taking any medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e78.2 (194)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e47. 2 (117)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e31 (77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\"\u003e\n \u003cp\u003e21.8 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\"\u003e\n \u003cp\u003e15.7 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eClass of medications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntibiotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.846\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntihypertensives and antidiabetics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e19.8 (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e15.7 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntiretroviral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntimalarial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntiglaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.12211668928087%\" valign=\"bottom\"\u003e\n \u003cp\u003eHerbal concoction\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.689280868385346%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.98100407055631%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.573948439620082%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.633649932157395%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eN, frequency; %, percentage frequency\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOphthalmic data of patients presenting with eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows the ophthalmic data of study participants. Many of the patients reported to have had both eyes affected (57.4%) with the conjunctiva being the most common site affected (94.4%). Most of the patients had previously used antimicrobials (67.3%), have had previous eye infections (63.7%) and a significantly higher proportion of females with previous application of mascara (p \u0026lt;0.001) and with duration of infection less than one-week (47.8%).With respect to monocular visual acuity, majority of patients had right eye visual acuity better than 6/18 (62.5%), followed by 3/60 -1/60 (11.7%) and with a fewer having visual acuity within the ranges of 6/24 to 6/60 (9.7%). Most patients had a left visual acuity within the ranges of 6/5 -6/6 (67.3%) and fewer proportion (6.9%) having visual acuity better than 6/24 but worse than 6/60. The most common patient-presenting symptoms were hyperemia/redness (59.3%), itching (58.1%) and eye pain (51.6%) and a smaller proportion with falling lashes (3.6%). The distribution of clinical presentations was as follows: conjunctivitis (66.1%), keratoconjunctivitis (14.5%), keratitis (8.1%), blepharoconjunctivis (9.6%), ocular trauma (2.8%), hordeolum (2.0%), preseptal cellulitis (0.8%), ophthalmia neonatorum (0.4%), uveitis (0.4%) and endophthalmitis (0.4%). Additionally, other associated conditions included dry eye syndrome (23.4%), headaches (10.1%), pterygium (5.6%), and pinguecula (2.0%) as shown in Table 2.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"744\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"70.96774193548387%\" colspan=\"5\" valign=\"bottom\" style=\"width: 99.8656%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2: Ophthalmic data of the study participants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003eTotal (N = 248)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003eFemales (N=156, 62.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003eMales (N=92, 37.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eEyes affected\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus dexter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e21 .0 (52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e11.7 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e9.3 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus sinister\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e21.8 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e14.1 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e7.7 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus uterque\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e57.3 (142)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e37.1 (92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eSite of the eye affected\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eEyelids/lashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e16.9 (42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e9.7 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e7.3 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eConjunctiva\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e94.4 (234)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e60.5 (150)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e33.9 (84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eCornea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e16.9 (42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious eye infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e63.7 (158)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e41.9 (104)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e21.8 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious use of antimicrobials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e67.3 (167)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e44.4 (110)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e23.0 (57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious use of contact lenses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious use of spectacles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e23.8 (59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e16.5 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e7.3 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious ocular trauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e31.0 (77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e18.1 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e12.9 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious application of mascara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e7.3 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e7.3 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePrevious ocular surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e10.1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.5 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.905\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eDuration of illness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u0026lt; 1 week\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e49.8 (123)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e28.7 (71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e21.1 (52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.226\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e2\u0026ndash;4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e15.8 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e10.1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e5.7 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026gt; 4 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e34.7 (85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e23.9 (59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e10.5 (26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePresenting visual acuity\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight eye; oculus dexter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eNot available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eFFL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e12.9(32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e6/5-6/18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e62.5 (155)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e39.1 (97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e23.4(58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e6/24-6/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e9.7 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e3/60-1/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e11.7(29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e7.3 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eBlind\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft eye; oculus sinister\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eNot available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e3.2 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eFFL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e12.9(32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e6/5-6/18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e67.3 (167)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e41.1(102)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e26.2 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e6/24-6/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e3/60-1/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e9.3(23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eBlind\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresenting patient symptoms\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eEye pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e51.6 (128)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e35.5 (88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e16.1 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eFalling Lashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e3.2 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eItching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e58.1 (144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e39.1 (97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e19.0 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eLacrimation/Watering\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e52.8 (131)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e33.5 (83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e19.4 (48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePhotophobia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e19.0 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e13.3 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.249\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eRedness/ Hyperemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e59.3 (147)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e36.3 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e23.0 (57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.509\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eSwelling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e17.7 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e10.1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e7.7 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.357\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eWhitish deposition/ discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e45.2 (112)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e26.2 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e19.0 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eForeign body sensation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e3.2 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eBurning sensation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e6.9 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/Investigation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eVisual acuity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e99.6 (247)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e62.9 (156)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e36.7 (91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eSlit lamp Biomicroscopy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e98.0 (243)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e62.1 (154)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e35.9 (89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.284\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eOphthalmoscopy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e98.4 (244)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e62.1 (154)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e36.3 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.590\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eMicrobial analysis\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e95.6 (237)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e60.9 (151)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e34.7 (86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical signs\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eEyelids/lashes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e95.2 (236)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e59.3 (147)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e35.9 (89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.445\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eCrust formation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eMisdirected\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eEyelids\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e57.3 (142)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e35.5 (88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e21.8 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.744\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eDrooping\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eSwelling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e31.9 (79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e21.0 (52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e10.9 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003ePapillae\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e8.9 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e5.2 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eCobblestones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eRashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eCrust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eConjunctiva\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e25.5(63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e15.8 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e9.7(24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eInjected\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e72.5(179)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e44.9 (111)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e27.5 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eLimbal pigmentation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eCornea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eTransparent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e85.9(213)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e56.5 (140)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e29.4(73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eOpacified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.6(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eAbrasions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e8.5(21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eUlcers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eLaceration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eSclera\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e91.5 (227)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e58.9(146)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e32.7 (81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003ePigmented\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e8.5(21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.0 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnterior chamber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eDeep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e97.6 (242)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e62.1 (154)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e35.5 (88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eShallow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003ePupils\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy (PERLLA)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e97.2 (241)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e62.1 (154)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e35.1 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eAbnormal (RAPD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eIris\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eHealthy (Dark and flat)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e99.2 (246)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e62.5 (155)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e36.7 (91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.704\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eProlapse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eLens\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eTransparent\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e79.8 (198)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e48.4 (120)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e31.5 (78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\" valign=\"bottom\"\u003e\n \u003cp\u003eOpacified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\" valign=\"bottom\"\u003e\n \u003cp\u003e20.2 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" valign=\"bottom\"\u003e\n \u003cp\u003e14.5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\" valign=\"bottom\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical presentation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eBlepharoconjunctivitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e2.4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eConjunctivitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e66.1 (164)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e44.8 (111)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e21.4 (53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eEndophthalmitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eHordeolum\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eKeratitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e4.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eKeratoconjunctivitis\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e14.5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e8.1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e6.5 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eOphthalmia neonatorum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePreseptal cellulitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eOcular trauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e2.8 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e1.2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eUveitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eDry eye syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e23.4 (58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e18.1 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e5.2 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003eHeadaches\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e10.1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e6.5 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.905\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePinguecula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e1.6 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.580645161290324%\"\u003e\n \u003cp\u003ePterygium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.967741935483872%\"\u003e\n \u003cp\u003e5.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\"\u003e\n \u003cp\u003e3.6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.295698924731184%\"\u003e\n \u003cp\u003e2.0 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.736559139784946%\"\u003e\n \u003cp\u003e0.912\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eN, frequency; %, percentage frequency\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrevalence of ocular fungi in patients with presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of the 237 ocular specimens subjected to culture (owing to the inability to obtain swabs from uncooperative minor patients), 9.3% (n = 22/237) were positive for different fungal species (Please see Table 3). Of the culture-positive fungal isolates, 72.7% (n = 16/22)\u003cem\u003e\u0026nbsp;were C. albicans and 9.1% (n = 2/22) as Penicillium citrinum (P. citrinum). \u0026nbsp;\u003c/em\u003eThe most prevalent fungal isolates recovered from patients clinically diagnosed with conjunctivitis and keratoconjunctivitis were \u003cem\u003eC. albicans\u003c/em\u003e (54.5 %; \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12/22 and 9.1 %; \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2/22 respectively). \u0026nbsp; Similarly, \u003cem\u003eC. albicans\u003c/em\u003e was frequently isolated from patients diagnosed with keratitis (4.5%; n = 1/22), and hordeolum (4.5%; n = 1/22) and with \u003cem\u003eAspergillus nomius (A. nomius)\u003c/em\u003e as the only fungus identified in preseptal cellulitis (4.5%; n = 1/22) as seen in \u003cstrong\u003eTable 3\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Prevalence of ocular fungi isolates in presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1052\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eType of eye infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003ePositive culture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003eNegative culture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\"\u003e\n \u003cul\u003e\n \u003cli\u003e\u003cem\u003eA.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/em\u003e\u003cem\u003efumigatus\u0026nbsp;\u003c/em\u003e\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\"\u003e\n \u003cul\u003e\n \u003cli\u003e\u003cem\u003eB.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;nomius\u003c/em\u003e\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\"\u003e\n \u003cp\u003e\u003cem\u003eC. albicans\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\"\u003e\n \u003cul\u003e\n \u003cli\u003e\u003cem\u003eC.\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;auris\u003c/em\u003e\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003e\u003cem\u003ekrusei\u003c/em\u003e\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\"\u003e\n \u003cp\u003e\u003cem\u003ePenicillium citrinum\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e% (frequency)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eBlepharoconjunctivitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.6 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eConjunctivitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e6.3 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e58.2 (138)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.8 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eHordeolum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.7 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eKeratitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e8.0 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eKeratoconjunctivitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.7 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e13.5 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003ePreseptal cellulitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eOphthalmia neonatorum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eOcular trauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eEndophthalmitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eUveitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.638783269961976%\" valign=\"bottom\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.55513307984791%\" valign=\"bottom\"\u003e\n \u003cp\u003e9.3 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.4106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e90.7 (215)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.931558935361217%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.171102661596958%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.844106463878327%\" valign=\"bottom\"\u003e\n \u003cp\u003e6.5 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.67680608365019%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.02661596958175%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.4 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.745247148288973%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.8 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003en, frequency; %, percentage frequency\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeterminants of fungi pathogens in patients with presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e presents a bivariate logistic regression analysis of \u0026nbsp; biographic, medical, and ophthalmic characteristics associated with prevalence of fungal ocular infections. \u0026nbsp;None of the patient characteristics was significantly associated with the prevalence of fungal ocular infections as shown in \u003cstrong\u003eTable 4\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"564\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4: Bivariate analysis of factors associated with prevalence of ocular fungal infections among ophthalmic patients from Ghana\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.00709219858156%\" colspan=\"3\" valign=\"bottom\"\u003e\n \u003cp\u003eBivariate regression\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBiographic and medical data\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003eAge years\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.99-1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.590\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e0-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e19-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.21-2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.489\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u0026ge;45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.38-2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eAkan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eEwe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eNortherner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.20-1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.204\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eAtheist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.01-1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.00-1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest level of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePreschool\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.16-4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.20-2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.526\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.19-1.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.408\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.03-2.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eBarber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eBeautician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eBusinessman/woman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eConstruction Worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eDressmaking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eFarming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePastor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eTrading\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eTransport Business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eWage or Salary Worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eWelding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation (Cat)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eFarmers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eNon-farmers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.21-2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.687\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.42-9.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.392\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eCohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.33-7.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.579\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.72-4.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003ePeptic ulcer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eSexually transmitted diseases\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"69.14893617021276%\" colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrently taking any medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.85-5.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eClass of medications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntibiotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntihyertensives and antidiabetics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.74-5.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntiretroviral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntimalarial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eAntiglaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eHerbal concoction\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eOphthalmic data\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eEyes affected\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus dexter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus sinister\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.59-7.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.255\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003eOculus uterque\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.30-3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003ePart of the eye affected\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eEyelids/lashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.21-2.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.635\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eConjunctiva\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.09-1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eCornea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.33-3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.953\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eDry eye syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.75-4.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eHeadaches\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.18-3.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePinguecula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePterygium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.09-5.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.777\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious eye infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.38-2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.924\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious use of antimicrobials\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.68-7.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious use of contact lenses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious use of spectacles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.43-3.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious ocular trauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.38-2.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.944\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious application of mascara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.07-4.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.576\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePrevious ocular surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.05-2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eDuration of illness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u0026lt; 1 week\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e2\u0026ndash;4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.12-2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.492\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026gt; 4 weeks\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.56-3.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresenting patient symptoms\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eEye pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.29-1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eFalling Lashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.07-1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eItching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.54-3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eLacrimation/Watering\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.55-3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003ePhotophobia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.42-3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.721\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eRedness/ Hyperemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.22-1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eSwelling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.88-6.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eWhitish deposition/ discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.37-2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eForeign body sensation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.28-6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.99290780141844%\"\u003e\n \u003cp\u003eBurning sensation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.156028368794326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.19858156028369%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.28-6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.652482269503546%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eBivariate regression analysis at a significance of p \u0026lt; 0.05. OR, odds ratio; CI, confidence interval; Ref, reference \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAntifungal susceptibility of recovered ocular fungi against standard antifungals, and native medicinal plants in patients with presenting eye infections in Ghana.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eZones of inhibition\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe antifungal susceptibility was evaluated using zone inhibition and broth dilution assays. Most of the fungal isolates tested showed multidrug resistance (MDR) against standard antifungal agents with minimal zones of inhibition, and a high (\u0026gt;10ug/mL) minimum inhibitory concentration (MIC) and minimum fungicidal concentrations (MFC) (\u003cstrong\u003eTables 5, 6, 7\u003c/strong\u003e). \u003cem\u003eA. fumigatus\u003c/em\u003e isolates were less susceptible to amphotericin B, itraconazole and fluconazole was observed whereas a greater susceptibility was seen for terbinafine. In contrast, terbinafine and itraconazole were less effective against \u003cem\u003eA. nomius\u003c/em\u003e. The growth of \u003cem\u003eC. albicans\u003c/em\u003e and \u003cem\u003eC. auris\u003c/em\u003e was inhibited to varying degrees in the presence of the antifungal agents. \u003cem\u003eC. \u0026nbsp;krusei\u003c/em\u003e and \u003cem\u003eP. citrinum\u003c/em\u003e exhibited similar reduce susceptibility to amphotericin B, itraconazole and fluconazole, but their growth was inhibited in the presence of terbinafine, as shown in \u003cstrong\u003eTable 5\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Zones of inhibition of standard antifungals and Ghanaian medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"677\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.190546528803544%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthanolic extract (mg/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.850812407680944%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.95864106351551%\" colspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMean zones of inhibition (mm)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. krusei\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. albicans\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. nomius\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. auris\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP. citrinum\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. fumigatus\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e20.33 \u0026plusmn; 0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e22.11 \u0026plusmn; 4.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.11 \u0026plusmn; 1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e22.67 \u0026plusmn; 1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e21.56 \u0026plusmn; 2.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e17.00 \u0026plusmn; 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.89 \u0026plusmn; 3.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e11.78 \u0026plusmn; 0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e19.033 \u0026plusmn; 0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e18.22 \u0026plusmn; 2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e12.00 \u0026plusmn; 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e12.44 \u0026plusmn; 1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.22 \u0026plusmn; 0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.22 \u0026plusmn; 1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 10.78 \u0026nbsp; \u0026nbsp; \u0026plusmn; 0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n 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width=\"12.812960235640649%\"\u003e\n \u003cp\u003e16.55 \u0026plusmn; 1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e17.0 \u0026plusmn; 1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e13.00 \u0026plusmn; 0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e10.67 \u0026plusmn; 0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e14.56 \u0026plusmn; 0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n 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width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n 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width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n 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\u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e18.11 \u0026plusmn; 1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e12.89 \u0026plusmn; 0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e17.56 \u0026plusmn; 0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.00 \u0026plusmn; 0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e11.33 \u0026plusmn; 0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e14.44 \u0026plusmn; 0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e13.56 \u0026plusmn; 0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e10.33 \u0026plusmn; 0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e10 \u0026plusmn; 3.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStandard control (\u0026micro;g/ml)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003eAMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e16.11 \u0026plusmn; 1.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e14.89 \u0026plusmn; 1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003eTER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e15.11 \u0026plusmn; 0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e17.56 \u0026plusmn; 1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e14.78 \u0026plusmn; 0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e14.78 \u0026plusmn; 1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e35.33 \u0026plusmn; 1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003eITZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e13.33 \u0026plusmn; 1.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.12223858615611%\"\u003e\n \u003cp\u003eFLZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e22.56 \u0026plusmn; 2.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e19.22 \u0026plusmn; 1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e23.22 \u0026plusmn; 1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.812960235640649%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCIN-\u003cem\u003eCinnamomum verum\u003c/em\u003e, SYZ-\u003cem\u003eSyzygium aromaticum\u003c/em\u003e, CO-\u003cem\u003eChromolaena odorata\u003c/em\u003e, AA-\u003cem\u003eAspilia africana\u003c/em\u003e, SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePhytochemicals\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe native medicinal plants contain\u0026nbsp;secondary metabolites such as tannins, alkaloids,\u0026nbsp;flavonoids,\u0026nbsp;glycosides,\u0026nbsp;triterpenoids,\u0026nbsp;and phytosterols in\u0026nbsp;majority of the extracts as shown in Table 6.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6: Major phytochemicals present in the extracts of Ghanaian medicinal plants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"648\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003ePhytoconstituent\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cem\u003eC. odorata\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cem\u003eS. alata\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cem\u003eC. verum\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cem\u003eS. aromaticum\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cem\u003eA. africana\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eTannins\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eAlkaloids\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eFlavonoid\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eGlycosides\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eSaponins\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003eTriterpenoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.444444444444443%\"\u003e\n \u003cp\u003ePhytosterols\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.59259259259259%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKey: + Detected. \u0026minus; Not detected.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMinimum inhibitory concentration (MIC)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe ethanolic extracts of medicinal plant species were moderately effective (relatively high zones of inhibition \u003cstrong\u003eTable 5\u003c/strong\u003e) at different concentrations against ocular fungal isolates (MIC values ranged between 6.25\u0026ndash;50mg/ml) as shown in \u003cstrong\u003eTable 7\u003c/strong\u003e.\u0026nbsp;\u003cem\u003eC. krusei\u003c/em\u003e was sensitive to \u003cem\u003eC. verum\u003c/em\u003e and \u003cem\u003eA. africana\u003c/em\u003e at a concentration of 6.25 mg/ml whereas the growth of \u003cem\u003eC. albicans\u003c/em\u003e were inhibited at a relative minimal concentration of 3.13 mg/ml. At a concentration of 6.25 mg/ml, \u003cem\u003eA. nomius\u003c/em\u003e were susceptible to extracts of \u003cem\u003eS. aromaticum\u003c/em\u003e whiles the growth of\u003cem\u003e\u0026nbsp;C. aurius\u0026nbsp;\u003c/em\u003eand were inhibited by\u003cem\u003e\u0026nbsp;C. verum. P. citrinum\u0026nbsp;\u003c/em\u003eand \u003cem\u003eA. fumigatus\u0026nbsp;\u003c/em\u003ewere respectively inhibited by \u003cem\u003eC. verum\u0026nbsp;\u003c/em\u003eand \u003cem\u003eA. africana\u003c/em\u003e at a concentration of 3.13 mg/ml as shown in \u003cstrong\u003eTable 7\u0026nbsp;\u003c/strong\u003eand \u003cstrong\u003eFigure 1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7. MIC of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003estandard antifungals and medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"666\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthanolic extract (mg/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. krusei\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. albicans\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. nomius\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. auris\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP. citrinum\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. fumigatus\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eCIN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eSYZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eCO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eAA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStandard control (\u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eAMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e1.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eTER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e7.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e15.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eITZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.61861861861862%\"\u003e\n \u003cp\u003eFLZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.26126126126126%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.963963963963964%\"\u003e\n \u003cp\u003e15.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.813813813813814%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.711711711711711%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.414414414414415%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCIN-\u003cem\u003eCinnamomum verum\u003c/em\u003e, SYZ-\u003cem\u003eSyzygium aromaticum\u003c/em\u003e, CO-\u003cem\u003eChromolaena odorata\u003c/em\u003e, AA-\u003cem\u003eAspilia africana\u003c/em\u003e, SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMinimum fungicidal concentration (MFC)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe MFC of native Ghanaian medicinal plant extracts were assayed against the recovered ocular fungi isolates using broth dilution method (Table 8). \u0026nbsp;All medicinal extracts showed an equal MFCs of 25\u0026nbsp;mg/ml against \u003cem\u003eC.\u003c/em\u003e \u003cem\u003ekrusei.\u0026nbsp;\u003c/em\u003eHowever, relative to \u003cem\u003eC. krusei\u003c/em\u003e, a minimal concentration of\u0026nbsp;12.5 mg/ml\u0026nbsp;\u003cem\u003eC. odorata, S. alata, and S. aromaticum\u0026nbsp;\u003c/em\u003ewere fungicidal to\u003cem\u003e\u0026nbsp;C. albicans. At a concentration of\u0026nbsp;\u003c/em\u003e25\u0026nbsp;mg/ml\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003eC. verum\u003c/em\u003e was fungicidal against both\u0026nbsp;\u003cem\u003eC. auris and P. citrinum\u0026nbsp;\u003c/em\u003ewith similar fungicidal effect observed for\u003cem\u003e\u0026nbsp;S. aromaticum\u0026nbsp;\u003c/em\u003eon \u003cem\u003eP. citrinum and A fumigatus\u0026nbsp;\u003c/em\u003eas shown in \u003cstrong\u003eTable 8.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8. MFC of standard\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;antifungals and Ghanaian medicinal plants against clinically recovered fungal isolates from patients with presenting eye infections in Ghana\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"534\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExtract /MFC (mg/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. krusei\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. albicans\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. nomius\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eC. auris\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP. citrinum\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eA. fumigatus\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCIN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSYZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl /MFC (\u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTER\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e125.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e250.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e250.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eITZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e250.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e250.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFLZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e250.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e125.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;500\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCIN-\u003cem\u003eCinnamomum verum\u003c/em\u003e, SYZ-\u003cem\u003eSyzygium aromaticum\u003c/em\u003e, CO-\u003cem\u003eChromolaena odorata\u003c/em\u003e, AA-\u003cem\u003eAspilia africana\u003c/em\u003e, SA-Senna alata, AMB-amphotericin B, TER-terbinafine, ITZ-itraconazole, and FLZ: fluconazole\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study report on the prevalence of fungal isolates from exterior eye infections, multi-drug resistance, and explore native Ghanaian medicinal plants as source of antifungal agents. Approximately ten percent of the ocular specimens were positive for fungal pathogens with the predominant species being \u003cem\u003eC. albicans\u003c/em\u003e. MDR was observed for common antifungal agents: fluconazole, itraconazole, and amphotericin B but not terbinafine used in the clinical treatment of oculomycosis. Ethanolic extracts of \u003cem\u003eS. aromaticum and C. verum\u003c/em\u003e showed high fungistatic activity on most ocular fungal isolates (MIC: 31.3\u0026ndash;12.5 mg/ml) whereas extracts of \u003cem\u003eC. odorata, S. alata and S. aromaticum\u003c/em\u003e exhibited potent fungicidal activity against the commonest fungal pathogen \u003cem\u003eC. albicans\u003c/em\u003e (MFC: 12.5mg/ml) implicated in ocular infections in this population.\u003c/p\u003e \u003cp\u003eOculomycosis is a leading cause of ocular morbidity and blindness, mostly misapprehended by ophthalmic clinicians as ocular infections of bacterial origin\u003csup\u003e32\u003c/sup\u003e. Such clinician misdiagnosis and mistreatment of ocular microbial infections culminate in antimicrobial resistance which is a public health concern due to negative patient outcomes (delays in healing and prolonged hospitalisation increases the financial cost of treatment and reduce the overall quality of life). The prolonged stay of patients increases the ophthalmic workload and places pressure on the limited resources of the system \u003csup\u003e33,34\u003c/sup\u003e. In this regard, microbial and/or laboratory investigations of clinically presented oculomycosis have a considerable impact on accurate diagnosis and administration of therapeutically effective antifungal therapy with a concurrent impact of improving clinical prognosis and decreasing complications\u003csup\u003e35,36,37\u003c/sup\u003e. The burden and etiology of ocular mycosis vary across regions and settings and changes over time thereby necessitating regional-specific estimates, characterisation of ocular fungal isolates and elucidation of efficacy of antifungal therapy to provide reference information for eyecare providers. Given the evidence gap in Ghana, we present preliminary data on the burden and etiology of ocular fungal infections and antifungal susceptibility of clinically used antifungal agents for treating oculomycosis in Ghana.\u003c/p\u003e \u003cp\u003eThe prevalence of eye infections of fungal etiology in this study was approximately ten percent. Globally, the burden of oculomycosis across different populations, geographical regions, and settings show no consensus patterns with prevalence estimates ranging from 0.05 to 97.0%\u003csup\u003e4,38,39\u003c/sup\u003e. A systematic review and meta-analysis by Phongkhun \u003cem\u003eet al\u003c/em\u003e. that estimated pooled prevalence of ocular candidiasis and endophthalmitis range between 7.4\u0026ndash;10.7%\u003csup\u003e5\u003c/sup\u003e. In a 6-year hospital-based study in Northern India, Chander and Sharma revealed a 7.26% positive fungal culture among ophthalmic patients with corneal ulcers\u003csup\u003e40\u003c/sup\u003e. Kowalski and colleagues in a retrospective laboratory review showed a proportion of fungal pathogens implicated in cases of infectious keratitis was estimated at 6.7%\u003csup\u003e41\u003c/sup\u003e. Our estimates are relatively low, about two to five times lower compared to results from India\u003csup\u003e38\u003c/sup\u003e, Paraguay\u003csup\u003e42\u003c/sup\u003e, and China\u003csup\u003e43\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study, we identified \u003cem\u003eC. albicans\u003c/em\u003e as the predominant fungal species implicated in ocular mycoses among ophthalmic patients from Ghana. The findings are consistent with studies in the United States\u003csup\u003e39\u003c/sup\u003e, United Kingdom\u003csup\u003e4445\u003c/sup\u003e, and Japan\u003csup\u003e46\u003c/sup\u003e, but contrast with results from Northern India\u003csup\u003e40,47\u003c/sup\u003e, China\u003csup\u003e43\u003c/sup\u003e, and Brazil\u003csup\u003e48\u003c/sup\u003e, Ethiopia\u003csup\u003e49\u003c/sup\u003e, that identified \u003cem\u003eAspergillus spp\u003c/em\u003e. and \u003cem\u003eFusarium spp\u003c/em\u003e as the predominant cause of oculomycosis\u003csup\u003e40,43,47,48,49\u003c/sup\u003e. The observed increased proportion of opportunistic yeast-like fungi, \u003cem\u003eC. albicans\u003c/em\u003e as opposed to filamentous fungi could be ascribed to patient characteristics (female sex and immunocompromised ailments and immunosuppressants) and high virulence factor of host pathogen\u003csup\u003e50,51,52\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe study showed multi-drug resistance of commonly used antifungal agents (amphotericin B fluconazole, itraconazole) on clinically recovered ocular fungal isolates from ophthalmic patients. The observed resistance of \u003cem\u003eA. fumigatus\u003c/em\u003e to fluconazole and itraconazole are consistent with remarkable trends of secondary azole resistance in these species whiles their concurrent superbug effects towards amphotericin B could ascribed to primary antifungal resistance mechanism\u003csup\u003e53,54,55,56\u003c/sup\u003e. As expected, \u003cem\u003eA. nomius\u003c/em\u003e showed azole resistance to itraconazole\u003csup\u003e53\u003c/sup\u003e. However, its resistance to terbinafine was worrying given that terbinafine is a clinically valid therapeutic surrogate to itraconazole owing to better clinical efficacy, safety and low cost\u003csup\u003e57\u003c/sup\u003e. Although \u003cem\u003eC. albicans\u003c/em\u003e and \u003cem\u003eC. auris\u003c/em\u003e showed susceptibility to all antifungal agents used in this work, the considerable reduce zone of inhibition of \u003cem\u003eC. albicans\u003c/em\u003e in the presence of amphotericin or itraconazole as opposed to terbinafine and fluconazole underscores the need for antimicrobial surveillance to monitor potential drug-resistance. The observed resistance of \u003cem\u003eCandida krusei\u003c/em\u003e and \u003cem\u003eP. citrinum\u003c/em\u003e to amphotericin B may be ascribed to altered genetic makeup of clinical isolates owing to its broad-spectrum clinical application/treatment\u003csup\u003e58\u003c/sup\u003e. Whiles the increased resistance of the above mentioned ocular isolates to azoles could be due to genetically resistance biofilms and efflux pumps activated to withstand high concentrations of these antifungal agents\u003csup\u003e52,59,60\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe medicinal extracts, \u003cem\u003eSyzygium aromaticum\u003c/em\u003e and \u003cem\u003eCinnamomum verum\u003c/em\u003e, demonstrated potent fungistatic activity against the clinically recovered fungal isolates including, \u003cem\u003eC. albicans\u003c/em\u003e, commonly implicated in oculomycosis in this ophthalmic population. The findings are consistent with previous reports of the plants antifungal effect\u003csup\u003e29,61,62,63\u003c/sup\u003e. Essid et al. shows excellent anti-Candida activity of essential oils of \u003cem\u003eC. verum\u003c/em\u003e with MIC values ranging from 31.25 to 62.5 \u0026micro;g/ml and moderate anti-Candida activity of S. \u003cem\u003earomaticum with MIC values\u003c/em\u003e 125 and 250 \u0026micro;g/ml\u003csup\u003e29\u003c/sup\u003e. Oresins and essential oils of \u003cem\u003eS. aromaticum\u003c/em\u003e have shown to exhibit antifungal activity against \u003cem\u003eC. albicans\u003c/em\u003e at significantly lower MIC values than antifungal agents\u003csup\u003e62\u003c/sup\u003e. The observed relatively high MIC could be explained by our exploration of crude plant extracts that contain a wide spectrum of unrefined phytochemicals that could mask the bioactivity other than essential oils that contain volatile aromatic compounds\u003csup\u003e64\u003c/sup\u003e. Our extracts showed fungicidal activity against ocular fungal isolates which corroborates with previous reports\u003csup\u003e65\u003c/sup\u003e. The results illuminate native medicinal plants as excellent source of antifungal agents that necessitates its optimization.\u003c/p\u003e \u003cp\u003eThe study presents the first comprehensive estimates of the prevalence and antifungal susceptibility profile of ocular fungal isolates among patients with presenting eye infections in Ghana and illuminate native medicinal plants with antifungal activity. The results are critical to optimize the eye health, and broadly inform institutional planning and actualizations of surveillance programs to monitor and curtail emerging multi-drug resistance. Despite the promising results of the phytochemical screening, the study was limited by the inability to isolate the bioactive compound responsible for the antifungal activity, and therefore, ophthalmic patients are strongly advised to desist from using native plants to treat oculomycosis. Although the study shed insights on the state of standard antifungal against clinically recovered ocular fungal isolates in patients, yet it is limited by the inability to evaluate commonly used ocular antifungals such as natamycin and voriconazole due to their inaccessibility. We recommend future studies evaluate the abovementioned antifungals and importantly expand the range of fungal strains beyond the ones recovered from infectious eyes in this study to enhance the overall clinical utility of the plant extracts. Given the logistic constraints, authors did not sequence the ocular fungal isolates, nonetheless, the combination of culture and PCR techniques provides robust sensitivity and specificity for fungi identification and characterization \u003csup\u003e66\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe proportion of positive fungal cultures in ocular infections was approximately ten percent, with \u003cem\u003eC. albicans\u003c/em\u003e identified as the predominant etiology. Clinical antifungal agents: amphotericin B, terbinafine, itraconazole, and fluconazole were found to be ineffective (minimal zone of inhibition, high MIC and MFCs) against the clinically recovered ocular fungal strains. The in vitro antifungal assays of the medicinal extracts showed antifungal activity which bespeaks its potential antifungal therapeutic prospects. Taken together, the evidence shown augments the current understanding on the epidemiology of oculomycosis and expands the horizon of showcasing novel source for bioprospecting lead compounds of potential clinical translation.\u003c/p\u003e \u003cp\u003e.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe multicenter, cross-sectional study was conducted from May 9, 2023, to June 15, 2023, among ophthalmic patients with suspected ocular infections of fungal etiology at three health facilities in Ghana: Anglican Eye Hospital, Jachie; St. Michaels Hospital, Pramso; and Kumasi South Hospital, Agogo. Patients\u0026apos; biographical and clinical data were collected using a structured questionnaire. Ocular specimens, specifically conjunctival swabs and corneal scrapings were examined for fungal pathogens. Antifungal susceptibility testing was performed using clinically used standard antifungal agents and native medicinal plants being investigated as potential antifungal agents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population consisted of patients who sought ophthalmic care/services for exterior eye infections at the Anglican Eye Hospital, Jachie; St. Michaels Hospital, Pramso; and Kumasi South Hospital from May 9 to June 15, 2023. Following informed consent (and written parental consent for minors), a purposive sampling strategy was used to enroll all patients presenting with signs and symptoms of external ocular infections. Patients presenting solely for optical correction, receiving systemic/topical antibiotics, or with \u0026nbsp;one week history of ocular surgery were excluded.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Anglican Eye Hospital, St. Michael\u0026apos;s Hospital, and Kumasi South Hospital were selected for this study because of their high outpatient department (O.P.D.) utilization, large catchment area, and rural-urban interactions. The Anglican Eye Hospital and St. Michael\u0026apos;s Hospital are in Bosomtwe, a rural district in Ghana, while Kumasi South Hospital is in the Asokwa Municipality, an urban settlement in the Ashanti Region of Ghana. All three facilities have either a permanent or visiting ophthalmologist, optometrists, ophthalmic nurses and opticians. They provide comprehensive eye care services, including medical history, visual acuity assessment, refraction, dispensing of refractive glasses, management of anterior and posterior segment pathologies, prescription of medications, and performance of scheduled surgeries. St. Michael\u0026apos;s Hospital and Kumasi South Hospital serve as immediate referral hospitals for the surrounding private and polyclinics. However, all clinical emergencies are referred to the Komfo Anokye Teaching Hospital, the only tertiary health facility in the region. The study facilities do not have a microbiology laboratory, so clinicians rely on empirical approaches for routine diagnosis and management of external ocular and periocular infections.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy variables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperation definition\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBlepharitis was characterized by symptoms such as gritty, itchy, and sore eyes with crusting and/or collarettes around the base of the eyelashes, as well as clogging of the meibomian gland and loss of eyelashes. Conjunctivitis was defined by conjunctival lesions with symptoms including hyperemia, chemosis, purulent discharge, and hemorrhage. Blepharoconjunctivitis presented with redness, dry and scaly eyelids, and symptoms of itchiness and burning. Keratoconjunctivitis was associated with complaints of dryness, itching, and mucous discharge in both the cornea and conjunctiva. Keratitis was characterized by corneal lesions with symptoms such as edema, cellular infiltration, pain, redness, and photophobia. Hordeolum was defined as swelling and tenderness of the eyelid with acute pain, photophobia, and mild epiphora. Ophthalmia neonatorum is a type of neonatal conjunctivitis that occurs within the first 28 days of life and is characterized by signs such as eyelid edema, erythema, and purulent discharge. Preseptal and orbital cellulitis showed similar features of painful swelling and/or tenderness of the eyelid with the later distinguished from the former by decreased vision and pain on eye motility\u003csup\u003e14\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBiographic and clinical data\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe patients sociodemographic, socioeconomic, and health status variables were gathered by the principal investigator and a trained research assistant using a structured questionnaire. A comprehensive vision assessment including visual acuity, slit lamp bio microscopy, and ophthalmoscopy was performed by a registered optometrist on all study participants. Subsequently, patient medical history, primary and secondary diagnosis, and antimicrobial therapy prescribed were extracted using a data collection form.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSpecimen collection and transport\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 237 ocular samples were collected from patients with external eye infections utilizing aseptic procedures. To obtain the conjunctival samples, the patients\u0026apos; eyes were positioned upward, and the lower tarsal plate of the eyelids and the fornix of the conjunctiva were gently rolled with a moistened saline cotton bud in repeated strokes from nasal to temporal and vice versa. For corneal ulcer and keratitis infections, a modified version of an earlier protocol was employed, which involved utilizing slit-lamp biomicroscopy and topical local anesthesia (1-2 drops of 0.5% fresh proparacaine) to firmly scrape the edges of the ulcer. However, no patients in the study had dacryocystitis and/or blepharitis, thus puncture and/or aspiration of the lacrimal sac and swabbing of the eyelids were not performed. The samples were then placed in a sterile, freshly prepared nutrient broth and transported within 1-3 hours in a standard triple packaging system (an absorbent cotton wrapping primary container enclosed in a sealed bag and kept in an insulated icebox with icepacks) from the study sites to the Faculty of Pharmacy and Pharmaceutical Sciences Laboratory at the Kwame Nkrumah University of Science and Technology for fungal microbial investigation. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLaboratory methods\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCharacterization of fungal ocular isolates\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOcular specimen was investigated for fungal pathogens using standard microbiology techniques. Briefly, ocular specimens were inoculated on a potato dextrose agar\u0026nbsp;(\u003cem\u003eOxoid Ltd. Basingstoke, Hants United Kingdom\u003c/em\u003e) and incubated at 37\u0026deg;C for 96 hours. Fungal positive culture was primarily confirmed by sub-culturing on Potato Dextrose Agar (PDA) supplemented with 100 \u0026micro;g/ml streptomycin, and 100\u0026micro;g/ml penicillin (Fisher Scientific, Schwerte, Germany). Morphologic characterisation, and microscopic identification were performed as seen in \u003cstrong\u003eTable 9\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 9: Identification and characterisation of clinically recovered ocular fungal isolates among ophthalmic patients from Ghana.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"715\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIsolate code\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003e\u003cstrong\u003eColony characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMicroscopic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIsolate name\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eKS1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eDeep cream color, round shape, pasty and smooth texture with a smell\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003ePseudo-hyphae with terminal chlamydospores; clusters of blastoconidia at septa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eCandida albicans\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eCream color, round, and smooth surface\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eClusters of small, budding, ovoid, and elongated cells. No pseudo-hyphae.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eCandida auris\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eSM14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eBluish-green color with a white border, powdery surface, and reverse color is yellow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eSeptate hyphae with conidiophores and metulae forming flask-shaped phialides bearing round conidia (\u0026ldquo;brush\u0026rdquo; appearance)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003ePenicillium citrinum\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eSM22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eCream color, round shape, pasty, and smooth surface\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eRound and oval cells parallel to pseudo-hyphae (appearance of logs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eCandida albicans\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eAE5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eGreen color with a white border, and smooth surface, and the reverse color is white\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eSeptate hyphae, with smooth and short conidiophores and an equal length of biseriate phialides and metulae forming the upper half of the vesicle. \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eAspergillus nomius\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eK1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eCream color with rough, mycelial fringe (wrinkle) surface\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eOval and elongated cells\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eCandida krusei\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.426573426573427%\"\u003e\n \u003cp\u003eKS3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.888111888111887%\"\u003e\n \u003cp\u003eBluish-green color with a powdery or velvety surface and the reverse color is white.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.37762237762238%\"\u003e\n \u003cp\u003eSeptate hyphae, smooth and short conidiophores. Compact uniseriate phialides (occupies upper two-thirds of the vesicle) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\"\u003e\n \u003cp\u003e\u003cem\u003eAspergillus fumigatus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eDNA extraction and quantification\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOcular fungal genomic DNA was extracted using the Quick-DNATM Fungal/Bacterial MiniPrep Kit (Zymo Research Group, California, USA) according to the manufacturer\u0026apos;s instructions. The quality of the extracted DNA was evaluated by agarose gel electrophoresis. The concentration of isolated DNA was determined using a Nanodrop ND 2000 at 260 nm (Thermo Scientific, USA).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePolymerase chain reaction\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe fungal internal transcribed spacer region (ITS1-5.8S rDNA-ITS2) and the D1/D2 domain of the 26S rRNA gene were amplified from genomic DNA isolated from ocular fungal samples using PCR ITS1 and ITS4 (Forward[F]d: ITS1\u0026apos;-5\u0026apos; TCCGTAGGTGAACCTGCG G3\u0026apos; and reverse[R]: ITS4-5\u0026apos;- TCCTCC GCTTATTGATATGC3\u0026apos;) and NL-1 and NL-4 (F: NL1- 5\u0026apos;-GCA TATCAATAAGCG GAGGAAAAG and R: NL4- 5\u0026apos;- GGTCCGTGTTTCAAGACGG) primer pairs (New England BioLabs Inc). PCR reactions were performed in a 20 \u0026micro;L reaction volume. Briefly, 1 \u0026micro;L of template DNA was added to a 19 \u0026micro;L master mix containing 12.5 \u0026micro;L of 10x Dream TaqTM Green Buffer (KCl, [NH4]2SO4 and 20 mM MgCl2), 0.5 \u0026micro;L each of forward and reverse primers, and 5.5 \u0026micro;L nuclease-free water. The denaturation step was performed at 95˚C for 5 minutes, followed by 25 amplification cycles of 95\u0026deg;C for 1 minute, 49\u0026deg;C (ITS1-F and ITS4-R) or 52\u0026deg;C (NL1-F and NL4-R) for 30 seconds, and 72\u0026deg;C for 2 minutes, with a final extension step of 10 minutes at 72\u0026deg;C. PCR products were examined on 1.5% agarose gels run in 1 x Tris-borate-EDTA (TBE) buffer and visualized by ethidium bromide staining under UV light.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAntifungal susceptibility testing\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAntifungal susceptibility testing was performed using the agar well diffusion method, as previously documented\u003csup\u003e67\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e68\u003c/sup\u003e, for common clinically used antifungal agents and medicinal plant extracts. To commence the procedure, a microbial inoculum of isolated ocular fungi with a McFarland standard of 0.5 (1x10\u003csup\u003e7\u003c/sup\u003e CFU/mL) was employed to create an even lawn of cells on a 20mm sterile plate with potato dextrose agar. Subsequently, equal diameter wells (6mm) were created using a sterile cork-borer, and each well was respectively seeded with 0.1ml of crude medicinal plant extracts of four different concentrations (100, 50, 25, 12.5 mg/ml). Clinical antifungal agents used as reference drugs were prepared by dissolving in DMSO (amphotericin B [AMB], terbinafine [TER], itraconazole [ITZ]) and distilled water (fluconazole [FLZ])\u003csup\u003e31\u003c/sup\u003e. Following incubation, the clear zones around the wells containing extracts and anti-fungal drugs (zone of inhibition) were measured in millimeters using a caliper and meter rule. The entire procedure was performed in triplicates to obtain the mean zone of growth inhibition. DMSO was and distilled water were tested as negative controls\u003csup\u003e67\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e68\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDetermination of Minimum Inhibitory Concentration and Minimum Fungicidal Concentration\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe minimum inhibitory concentration (MIC) of crude medicinal plant extracts were evaluated using the broth dilution assay as previously described\u003csup\u003e67\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e69\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e70\u003c/sup\u003e. Two-fold serial dilutions of the extracts or standard antifungal agents (AMB, FLZ, ITZ, and TER) were prepared in sterile 96-well microtiter plates. One hundred microliters of each two-fold serial dilution of crude extract were transferred into the wells, followed by the addition of 100\u0026nbsp;\u0026mu;l\u0026nbsp;of double strength nutrient broth containing an inoculum size of approximately 2.0 x 10\u003csup\u003e5\u003c/sup\u003e CFU/ml. The plates were incubated for 24 hours at 37\u0026deg;C. Afterward, 20 \u0026micro;L of a 1.25 mg/mL 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (M.T.T) solution were added to each well, and the plates were further incubated for 30 minutes at 37\u0026deg;C. The MIC was determined as the lowest concentration of extract or antibiotic that completely inhibited the growth of the organism in the microdilution wells, as detected by the absence of purple coloration after MTT addition during a 24-hour incubation period at 37\u0026deg;C. All assays were performed in triplicate. Furthermore, the minimum fungicidal concentration (M.F.C) was performed as previously described\u003csup\u003e69\u003c/sup\u003e. \u0026nbsp;For each well that displayed no obvious purple coloration indicative of growth from the MIC assay, 20 \u0026micro;L of suspension was transferred into new plates containing 100 \u0026micro;L freshly prepared nutrient broth. The microtiter plates were then incubated at 37\u0026deg;C for 24 hours. Following the incubation period, 25 \u0026micro;L of 125 mg/mL MTT was introduced into each well and incubated at 37\u0026deg;C for 30 minutes to facilitate the proliferation of microorganisms. MFC was defined as concentration at which no visible growth was observed after the introduction of the MTT dye\u003csup\u003e67\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e69\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e70\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCollection, authentication, and preparation of medicinal plants\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe fresh leaves of \u003cem\u003eS. alata, C. odorata,\u003c/em\u003e and \u003cem\u003eAspilia africana\u003c/em\u003e were collected from Kwahu-Asakraka (6\u0026deg;38\u0026prime;05.2\u0026Prime;N 0\u0026deg;41\u0026prime;20.6\u0026Prime;W) in the Eastern Region of Ghana between June and July 2023. Similarly, dried flower buds of \u003cem\u003eS. aromaticum\u003c/em\u003e and powdered stem bark of \u003cem\u003eC. verum\u003c/em\u003e were purchased from a spice retail shop from a local market in the Ashanti Region of Ghana (latitude 6.6886\u003csup\u003eo\u003c/sup\u003e N, longitude 1.6156\u003csup\u003eo\u003c/sup\u003e W), in the Ashanti region of Ghana in July 2023. The authentication of the medicinal plants was performed by an expert botanist and the herbarium accession number of the \u003cem\u003eS. alata (\u003c/em\u003eKNUST/HMI/2023 L016), \u003cem\u003eA. africana (\u003c/em\u003eKNUST/HMI/2023 L017), \u003cem\u003eC. odorata (\u003c/em\u003eKNUST/HMI/2023 L018) \u003cem\u003eC. verum\u003c/em\u003e (KNUST/HMI/2023 SB027) and \u003cem\u003eS. aromaticum\u003c/em\u003e (KNUST/HMI/2023 FB001) respectively stored at the reference repository of the Department of Herbal Medicine at the Kwame Nkrumah University of Science and Technology in Kumasi, Ghana. After collection, the fresh leaves of \u003cem\u003eS. alata\u003c/em\u003e, \u003cem\u003eC. odorata\u003c/em\u003e, and \u003cem\u003eA. africana\u003c/em\u003e were washed under running tap water and left to air-dry at room temperature for six days to remove moisture. The dried leaves and dried flower buds of \u003cem\u003eS. aromaticum\u003c/em\u003e and \u003cem\u003eC. verum\u003c/em\u003e were homogenized into a fine powder and stored in an airtight plastic container at room temperature until use.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eExtraction and phytochemical analysis of plants\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEthanolic extracts of medicinal plants were obtained using cold maceration method as previously documented. Phytochemical screening performed on plant extracts to identify bioactive compounds as described previously\u003csup\u003e66,67,\u003c/sup\u003e\u003csup\u003e71\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e. Briefly, to elucidate the presence of tannins, a 100 mg sample of each plant extract was mixed with 3 ml of distilled water and 2 drops of 10% alcoholic FeCl\u003csub\u003e3\u003c/sub\u003e solution. The formation of a deep blue or green coloration signified the presence of tannins. For saponins, a 100 mg of plant extract was mixed with 3 ml of distilled water, resulting in persistent foam formation as a marker of saponins. To test for alkaloids, a 100 mg sample extract was mixed with 3 ml of distilled water and vigorously shaken. A 1 ml sample of each solvent extract was then treated with 4 drops of 1% HCl, heated at 60\u0026deg;C for 60 seconds, and cooled. Next, 5 drops of Wagner\u0026apos;s reagent were added to the solution, and the formation of a reddish-brown precipitate indicated the presence of alkaloids. To test for terpenoids, A mass of 100 mg of each of the plant extract was added to three (3) mL of distilled water and mixed vigorously. A volume of 0.5 mL of chloroform was added to one (1) mL of the solvent extracts in different test tubes and treated with two (2) drops of concentrated H\u003csub\u003e2\u003c/sub\u003eSO\u003csub\u003e4\u003c/sub\u003e slowly down the test tube wall. A ring formation of reddish-brown precipitate showed the occurrence of terpenoids. To test for flavonoids, a mass of 100 mg of each of the plant extract was added to three (3) mL of distilled water and mixed vigorously. One (1) mL of each solvent extract was treated in their separate test tubes with a few drops of 20% NaOH. The presence of flavonoids was demonstrated by the production of a bright yellow color that became colorless with the addition of dilute HCl. Liebermann\u0026rsquo;s test was performed to ascertain the presence of glycosides. Briefly, crude extract was combined with equal volumes of chloroform and acetic acid (2ml), and the resulting mixture was cooled in an ice bath and cautiously added with concentrated sulfuric acid. The presence of a color change from violet to blue to green indicated the presence of glycoside\u003csup\u003e66,\u003c/sup\u003e\u003csup\u003e68\u003c/sup\u003e\u003csup\u003e,70\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eQuality assurance and control\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe study used a modified structured questionnaire to collect demographic and clinical data. Questionnaires were written in English and administered by the principal investigator and a trained research assistant. The questionnaire was explained in the local dialect for study participants who could not understand instructions in English. Study data were double-checked for accuracy and completeness. At the facility, all test tubes containing eye samples were well labeled to prevent mix-ups. Laboratory reagents and culture media for the experiments were checked for expiration dates, and sterility control was performed to determine the integrity of the media, such as freedom from contamination. Evaluation of media performance and/or functionality was performed using the American Type Culture Collection (A.T.C.C.) standard reference strains of \u003cem\u003eC. albicans\u003c/em\u003e \u003cem\u003eATCC\u0026nbsp;\u003c/em\u003e10231. Medicinal plant species used for studies were accurately identified and verified by an experienced botanist.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData protection and management\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe hardcopy of the completed questionnaires was securely stored in a locked location, accessible only to the principal investigator and research consultant. Similarly, the non-aggregated data set in softcopy was protected by a strong alphanumeric password. The research report presented to institutions and for publication was aggregated, making it impossible to trace individual study participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA hierarchical ethical review protocol was followed to conduct this study. The study protocol was modified from a previous investigation and approved by the Committee on Human Research, Publication and Ethics (C.H.R.P.E.) of the Kwame Nkrumah University of Science and Technology and the Komfo Anokye Teaching Hospital (reference number: CHRPE/AP/116/24). Written informed consent was obtained from all adult participants. For minors, written informed consent was obtained from caregivers after the study protocol was explained to the best of their understanding. The study adhered to the tenets of the Declaration of Helsinki, and all laboratory procedures were performed in accordance with the guidelines of the Clinical Laboratory Standard Institute (C.L.S.I.). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were entered and processed in Microsoft Excel before being exported to a Windows-compatible version of a statistical package and service solution (IBM Corporation IBM\u0026reg; SPSS\u0026reg; Statistics for Windows, version 25.0 Armonk, NY). The Kolmogorov-Smirnov statistic was used to determine normality. Biographical, medical, and ophthalmic characteristics were presented, and the sex difference was examined using chi-squared analysis. Cross-tabulations with frequencies and percentages were used to illustrate clinical diagnosis, cultural status, and antifungal therapy. All antifungal susceptibility assays were performed in triplicate with identical colonies, and inhibition zones are presented as mean \u0026plusmn; standard deviation. The association between sample characteristics and the prevalence of ocular fungal infections was examined using bivariate logistic regression with a significance level of p \u0026lt;0.05.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eA.E.H.: Anglican Eye Hospital, A.M.R.: Antimicrobial Resistance, M.D.R.: Multidrug-Resistance C.H.A.G.: Christian Health Association of Ghana, C.H.R.P.E.: Committee on Human Research Publication and Ethics, C.L.S.I.: Clinical Laboratory Standard Institute Guidelines, R, resistant; S.D.: Standard Deviation, M.I.C.: Minimum Inhibitory Concentration, M.F.C.: Minimum Fungicidal Concentration, A.M.B. B.: Amphotericin B, \u0026nbsp;T.E.R.: Terbinafine, I.T.Z.: Itraconazole, F.L.Z.: Fluconazole, M.T.T.: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Acknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their sincere gratitude to the authorities and staff of the Anglican Eye Hospital, St. Michaels Hospital, and Kumasi South Hospital for allowing the study to be conducted and to the study participants for their willingness to participate. We gratefully acknowledge the support of the Faculty of Pharmacy and Pharmaceutical Sciences, the Department of Theoretical and Applied Biology, and the Department of Optometry and Visual Sciences all at K.N.U.S.T for the use of their resources and facilities for the study. Special thanks to Dr. Vivian Boamah (Department of Pharmacology, K.N.U.S.T., Kumasi, Ghana), Mr. Clifford Asare (Department of Herbal Medicine, Faculty of Pharmacy and Pharmaceutical Sciences, K. N.U.S.T., Kumasi, Ghana), Mrs. Millicent Ogyiri and Mr. Bismark Ofori (Department of Microbiology, Faculty of Pharmacy and Pharmaceutical Sciences, K.N.U.S.T., Kumasi, Ghana) for their technical assistance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.O.B. and I.O.D.J contributed equally to the work. A.O.B.: project administration; methodology; investigation; software; formal analysis; writing-review and editing. I.O.D.J.: project administration, conceptualization, experimental design, methodology, data curation; visualization; software; formal analysis; resources; writing original draft; writing\u0026ndash;review and editing; L.G.: methodology, investigation, writing- reviews and editing. K.O.A.: resources, experimental design, methodology, writing-review and editing. K.B.: project administration; conceptualization; experimental design; methodology; data curation; resources; writing-review and editing, supervision. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was supported in part by a Sigma Xi Grant in Aid for Research from the Scientific Research Honor Society (Grant ID: G2022315-2372) to Dr. Carolyn Yanney. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll relevant data and materials supporting the conclusion of this article is/are available within the manuscript and its supporting information files. The corresponding author can be contacted for any other additional information required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo conduct this study, a hierarchical ethical consideration protocol was followed. Written permission was obtained from the authorities of the Anglican Eye Clinic, St. Michaels Hospital and Kumasi South Hospital The study protocol was modified from a previous investigation and approved by the Committee on Human Research, Publication, and Ethics (C.H.R.P.E.), of Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital (reference number: CHRPE/AP/116/24). Written informed consent was obtained from all adult participants. For minors, written informed consent was obtained from caregivers after the study protocol was explained to the best of their comprehension. The study adhered to the tenets of the Declaration of Helsinki, and all laboratory procedures were performed in accordance with the Clinical Laboratory Standard Institute (C.L.S.I) guidelines. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHoffman, J. J., Burton, M. J. \u0026amp; Leck, A. Mycotic keratitis\u0026mdash;a global threat from the filamentous fungi. \u003cem\u003eJournal of Fungi\u003c/em\u003e \u003cstrong\u003e7\u003c/strong\u003e, 273 (2021).\u003c/li\u003e\n\u003cli\u003eBrown, L., Leck, A. K., Gichangi, M., Burton, M. J. \u0026amp; Denning, D. W. 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Phytochemical analysis of some medicinal plants. \u003cem\u003eJournal of phytology\u003c/em\u003e \u003cstrong\u003e3\u003c/strong\u003e, (2011).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"nature-portfolio","isNatureJournal":true,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"","title":"Nature Portfolio","twitterHandle":"","acdcEnabled":false,"dfaEnabled":false,"editorialSystem":"ejp","reportingPortfolio":"","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Ocular mycoses, antimicrobial resistance, natural products, phytoconstituents, lead-compounds, Cinnamomum verum and Syzygium aromaticum, drug discovery","lastPublishedDoi":"10.21203/rs.3.rs-4656890/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4656890/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eOcular mycoses have a debilitating impact on ocular health and quality of life. However, the burden and etiology of ocular mycoses and the efficacy of clinical antifungal agents used in the management of ocular fungal infections remain unclear. The study assesses the prevalence of ocular fungal pathogens and multi-drug resistance patterns, and further explored native medicinal plants as a source of antifungal agents in Ghana.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this multicenter, cross-sectional study, biographic, medical, and ophthalmic data were collected using a structured questionnaire, and conjunctival swabs and corneal samples were collected for microbiological characterization and antifungal susceptibility testing. Patient demographic and clinical data were stratified by sex and differences were tested using chi-squared analysis. Microbiological data were presented as proportions, means, and standard deviations. Bivariate logistic regression was used to test the association between patient characteristics and the likelihood of isolating fungal pathogens from the eyes of persons with presenting eye infections.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eApproximately ten percent (9.36%) of ocular specimens were positive for fungal culture with the predominant fungal etiology being Candida albicans. Multi-drug resistance was observed for clinically used antifungal agents; amphotericin B and fluconazole, itraconazole, terbinafine. Alternatively, ethanolic extracts of \u003cem\u003eCinnamomum verum\u003c/em\u003e (\u003cem\u003eC. verum\u003c/em\u003e) and \u003cem\u003eSyzygium aromaticum\u003c/em\u003e (\u003cem\u003eS. aromaticum\u003c/em\u003e), demonstrated potent fungistatic and fungicidal activity against the common implicated pathogen, \u003cem\u003eCandida albicans\u003c/em\u003e (\u003cem\u003eC. albicans\u003c/em\u003e).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOverall, the study broadens our understanding of the pathogenesis of ocular mycoses in Ghana and the implications of clinical use of antifungal treatments. Leveraging on the medicinal plant screening, we propose characterization of the bioactive compound(s) in \u003cem\u003eC. verum\u003c/em\u003e and \u003cem\u003eS. aromaticum\u003c/em\u003e for clinical translation into ocular antifungal therapeutics.\u003c/p\u003e","manuscriptTitle":"Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-17 01:33:01","doi":"10.21203/rs.3.rs-4656890/v1","editorialEvents":[],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"communications-medicine","isNatureJournal":true,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"commsmed","sideBox":"Learn more about [Communications Medicine](http://www.nature.com/commsmed)","snPcode":"43856","submissionUrl":"https://mts-commsmed.nature.com/cgi-bin/main.plex","title":"Communications Medicine","twitterHandle":"@commsmedicine","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Communications Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0a91af7f-7f5e-4749-919a-9fbf9777e5f5","owner":[],"postedDate":"August 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":33958259,"name":"Health sciences/Medical research/Epidemiology"},{"id":33958260,"name":"Biological sciences/Microbiology/Fungi/Fungal pathogenesis"},{"id":33958261,"name":"Health sciences/Diseases/Infectious diseases/Fungal infection"},{"id":33958262,"name":"Health sciences/Health care/Public health/Epidemiology"}],"tags":[],"updatedAt":"2024-09-04T14:12:00+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-17 01:33:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4656890","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4656890","identity":"rs-4656890","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}