Successful boric acid treatment of Aspergillus niger infection in an exenterated orbit

Aspergillus niger infection of an exenterated orbit is a very rare occurrence. Treatment includes extensive surgical debridement with socket lavage with 0.6% hydrogen peroxide, oral itraconazole, and local amphotericin B. We describe a case of A. niger infection in an exenterated orbit, unresponsive to local amphotericin B, that was successfully treated with weekly boric acid irrigation. We conclude that local and conservative therapy with 2.5% boric acid solution in 70% ethanol is a useful option in the management of these cases.