Tuesday, March 22, 2011

Mycotic Keratitis

Mycotic keratitis is an inflammation of the cornea caused by fungi. It is a mycotic infection of the eye cornea, which the transparent frontal part of the globe. This type of keratitis is usually caused by three types of fungi: Fusarium spp, Aspergillus fumigatus, and Candida. The symptoms of mycotic keratitis are blurred vision, a red and painful eye that does not improve when contact lenses are removed, or on antibiotic treatment, increased sensitivity to light (photophobia), and excessive tearing or discharge. A presumptive diagnosis of fungal keratitis requires immediate empirical treatment. Natamycin ophthalmic suspension is the drug of choice for filamentous fungal infection (Fusarium spp and Aspergillus fumigatus). Fluconazole ophthalmic solution is recommended for Candida infection of the cornea. Amphotericin B eye drops may be required for non-responding cases, but can be quite toxic and requires expert pharmacist for preparation.

Mycotic keratitis was first described by Leber in 1879. Although fungi are not a common cause of corneal infection, it represents one of the major causes of infectious keratitis in tropical areas of the world. Considering fungus as a possible cause of infectious keratitis is important because devastating ocular damage can result if it is not diagnosed and treated promptly and effectively.