fungal keratitis introduction , pathogenesis , treatment , diagnosis .

1. Sushant shah
2nd
year Bsc. optometry
Nethradhama college of optometry
Fungal Keratitis

2. FUNGAL KERATITIS
OR
KERATOMYCOSIS

3. Introduction
A fungal keratitis is an 'inflammation of
the eye's cornea' (called keratitis) that results from
infection by a fungal organism.
One of the major cause of infectious keratitis in tropical
countries
• Typically seen after injury with vegetable matter , use of
contact lens

4. Predisposing factors
injury with vegetable matter

5. Predisposing factors contd..
• use of contact lens

6. Causative organisms
 Hyaline Filamentous fungi –
Aspergillus , Penicillum , Fusarium
Dematiacious filmentous fungi -
Culvularia, Cladosporium
Yeast –
Candida albicans

7. Epidemiology
Aspergillus species is the most common organism responsible for
fungul keratitis world wide .
Aspergillus: 27-64 %
Fusarium: 6-32 %
Penicillum: 2-29 %

8. Pathogenesis

9. Clinical features
• Slow progression
• Signs more & Symptoms less
Symptoms
• Defective vision
• Photophobia
• Watering
• Marked ciliary & conjunctival congestion

10.  Signs
• Corneal ulcer
• Dry looking ulcer with irregular border
• Satellite lesions around ulcer
• Hypopyon – thick & immobile
• Wesseley ring – deposition of immune
complexes & inflammatory cells
Clinical features contd..

11. Wesseley ring
Hypopyon

13. Diagnosis
• Careful clinical evaluation correlating typical
history, symptoms and signs
• Culture of corneal scrapping
• USG – endophthalmitis – exudates in the
vitreous

14. Suggested Lab Workup
 KOH wet mount with or without stain .
 Gram staining.
 LCB
 Culture in SDA(sabooraud's dextrose agar) and blood agar

15. Treatment
 Medical
Filamentous fungi –
Natamycin
Amphoterecin B
Miconazole ointment
Yeast –
Nystatin

16.  Surgical
•Corneal graft
•Covered with conjunctival flap