fungal keratitis
TRANSCRIPT
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Sushant shah2nd year Bsc. optometry
Nethradhama college of optometry
Fungal Keratitis
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FUNGAL KERATITIS OR KERATOMYCOSIS
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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
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Predisposing factorsinjury with vegetable matter
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Predisposing factors contd..• use of contact lens
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Causative organisms
Hyaline Filamentous fungi – Aspergillus , Penicillum , Fusarium
Dematiacious filmentous fungi - Culvularia, Cladosporium Yeast – Candida albicans
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Epidemiology
Aspergillus species is the most common organism responsible for fungul keratitis world wide .
Aspergillus: 27-64 % Fusarium: 6-32 %
Penicillum: 2-29 %
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Pathogenesis
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Clinical features • Slow progression• Signs more & Symptoms less
Symptoms
• Defective vision • Photophobia • Watering • Marked ciliary & conjunctival congestion
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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..
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Wesseley ring
Hypopyon
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Diagnosis
• Careful clinical evaluation correlating typical history, symptoms and signs
• Culture of corneal scrapping
• USG – endophthalmitis – exudates in the vitreous
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Suggested Lab Workup
KOH wet mount with or without stain . Gram staining. LCB Culture in SDA(sabooraud's dextrose agar) and blood agar
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Treatment
Medical
Filamentous fungi – Natamycin Amphoterecin B Miconazole ointment Yeast – Nystatin Amphotericin
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Surgical •Corneal graft•Covered with conjunctival flap
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