Clinical characteristics and outcome of Candida keratitis

To characterize the clinical features and therapeutic outcome of Candida keratitis.

Retrospective, observational case series.

We reviewed 26 patients treated for Candida keratitis, including two with recurrent keratitis and one with bilateral infection.

Of 29 keratitis episodes resulting from Candida albicans (n = 20) or Candida parapsilosis (n = 9), 16 (55%) complicated chronic ocular surface disease, and nine (31%) followed previous keratoplasty. Only two were clinically suspected to have keratomycosis at initial presentation, and 21 (72%) used antibacterial therapy before corneal scrapings. Reconstructive keratoplasty occurred more often in previously grafted eyes (P = .03). Visual outcome was 20/60 or better in six (100%) medically treated eyes with good presenting visual acuity but in only five eyes (24%) with worse initial vision (P = .002).

Candida keratitis is an opportunistic infection of a compromised cornea that often is misdiagnosed initially and, despite antifungal therapy, occasionally requires corneal grafting.