Globally, around 1.2 million cases of fungal keratitis are reported every year. And tropical countries records a higher incidence of fungal keratitis.
What actually Fungal Keratitis is ?
Fungal keratitis is the infection of the cornea , caused by fungus. Here the pathologic fungi is capable of invading the ocular surface and produces typical corneal destruction and ulcer development .
Which organism causes Fungal Keratitis ?
Organisms responsible for fungal keratitis includes
- Aspergillus species
- Fusarium species
- Candida species
Fungal Keratitis most common causes
Fungal keratitis often occurs following a ocular trauma. It can also occur due to exposure to fungal pathogens from organic matte.
So agricultural workers are at greater risk for development of fungal keratitis.
Particularly involving plants related parts in form of thorns, grains, hay etc producing eye trauma are dangerous in nature.
Riak Factors of Fungal Keratitis
Risk factors for fungal keratitis include
- Random use of local steroid eye drops
- Occular injuries
- Poor personal occular hygiene
- And also regular contact lens wearing
- Weak immune system status or
- Immunocompromised people
What are symptoms of fungal keratitis ?
- Pain in eye after trauma
- Presence of foreign body sensations
- Eye redness will be present
- Blurred vision producing problems in vision
- Excessive Sensitivity to light
- BIt might lead to excessive tear secretion
- Eye discharge can also be present
Fungal keratitis if left untreated, it can become a serious eye issue and will result in vision loss or blindness.
Diagnosis of Fungal Keratitis
The early stage of fungal keratitis remains a diagnostic and therapeutic challenge to the ophthalmologist. Because of lack of delayed diagnosis is common.
Corneal scrapping and staining, Eye Examination, Slit Lamp examination are usually done.
Diagnosing and treating fungal keratitis in eye poses significant challenges. A delay in diagnosis may lead to irreversible consequences of corneal fungal infections, which are though preventable.
Fungal keratitis tends to exhibit poorer treatment outcomes compared to bacterial keratitis, with delayed diagnosis and a shortage of effective antifungal agents being key contributors to these suboptimal results.
However, recent years have witnessed substantial advancements in both the diagnosis and treatment of this condition
Treatment of Fungal Keratitis
Medical treatment for Fungal Keratitis
Topical antifungals eye-drops are the golden medication for the management of fungal keratitis. In resistant cases, there should be an addition of systemic antifungal to bring effectiveness.
Topical natamycin 5% is usually the first treatment of choice .Other topical agents used in the treatment of fungal keratitis includes amphotericin B 0.15-0.3%, voriconazole 1%, econazole 1%, itraconazole 1%, and miconazole 1%.
Non-surgical Conservative Management
Periodic debridement is commonly done for management of fungal keratitis. This helps by
- Removing necrotic tissue
- Reduces the organism load enh
- Also enhances the penetration of the drugs
Surgery for Fungal Keratitis
Keratoplasty for fungal keratitis
If those medical treatments fails, then keratoplasty might be needed to cure fungal keratitis .Usually A lamellar or penetrating keratoplasty is done
For perforation in fungal keratitis
For treatment of perfection a patch graft or a therapeutic transplant is usually performed.
Complications of Fungal Keratitis
- Mild to severe corneal scarring
- Corneal perforation
- Anterior segment disruption
- Glaucoma
- Endophthalmitis resulting in evisceration
- Permanent blindness
Prevention of Fungal Keratitis
Proper eye protection should be taken during crop handling and cultivation. As most causes of fungal keratitis is due to occular trauma by vegetative materials, farmers should be cautious.Not only farmers, normal people also should use protective measures to avoid keratitis.
Contact lens wearers should must be cautious more.Patients should be educated correctly about the proper use of contact lenses and about their cleaning products.
