Fungal Keratitis: What You Need to Know

When dealing with fungal keratitis, a serious corneal infection caused by fungi such as Fusarium or Aspergillus. Also known as mycotic keratitis, it can threaten vision if not treated quickly.

One of the biggest risk factors is contact lens use, especially when lenses are worn overnight or cleaned with tap water. Improper hygiene creates a perfect environment for fungal spores to settle on the eye surface. Trauma from a plant or nail injury can also introduce fungi directly into the cornea, and people with weakened immune systems are more vulnerable.

Typical symptoms include a red eye, pain, blurred vision, and a gritty feeling that doesn't improve with artificial tears. A white or feathery‑like infiltrate often appears on the cornea, and sometimes a hypopyon (pus in the anterior chamber) develops. These signs tell the clinician that the infection is not bacterial and may need a different approach.

Diagnosis starts with a slit‑lamp examination, where the doctor looks for characteristic fungal filaments. If the picture is unclear, they may take a corneal scrape for culture or use confocal microscopy, which can visualize fungal hyphae in real time. Early lab confirmation shortens the time to effective therapy.

Effective treatment relies on antifungal eye drops, such as natamycin 5% or voriconazole 1%. Natamycin remains the first‑line drop for most filamentous fungi, while voriconazole covers resistant strains and deeper infections. In severe cases, oral antifungals like itraconazole or fluconazole complement the drops. The goal is to eradicate the organism while preserving corneal structure.

Using ocular steroids, for example dexamethasone, can be a double‑edged sword. Steroids reduce inflammation but also suppress the immune response, allowing fungi to spread. Current guidelines advise withholding steroids until the infection is under control, then using them sparingly to manage scarring. This balanced approach prevents vision loss while avoiding drug‑induced worsening.

Prevention focuses on hygiene: clean lenses with the proper solution, avoid tap water, and replace cases regularly. After any eye injury, seek prompt medical care, especially if you work outdoors or handle plants. Follow‑up visits are crucial; even after symptoms improve, the fungus can linger and cause recurrence.

Below you’ll find a curated collection of articles that dive deeper into specific medicines, safety tips, and treatment comparisons that relate to fungal keratitis management. From the nuances of steroid use to the best antifungal options, these posts give you actionable insights you can apply right away.