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Toxic non-inflammatory fungal keratitis
Praveen Subudhi1, Sweta Patro1, Sabyasachi Pattanayak2
1Department of Cornea, Ruby Eye Hospital, Berhampur, Odisha, India.
Indian Journal of Ophthalmology
|May 3, 2022
Summary
A new condition, toxic non-inflammatory fungal keratitis, is identified in patients with fungal ulcers after topical steroid use. This entity presents with less pain and better vision than expected, indicating potential steroid misuse.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis is a serious eye infection.
- Topical steroid use can alter the clinical presentation of infectious keratitis.
Purpose of the Study:
- To describe a novel clinical entity: toxic non-inflammatory fungal keratitis.
- To highlight the importance of considering this entity in specific patient populations.
Main Methods:
- Retrospective analysis of patients with infective keratitis and prior topical steroid use.
- Corneal scraping analysis using 10% KOH mount and microbial culture.
- Documentation of clinical signs, injury details, and treatment outcomes.
Main Results:
- Patients presented with reduced pain and improved visual acuity.
- KOH mounts showed abundant fungal filaments with minimal inflammatory cells.
- Aspergillus and Fusarium species were the most common fungal isolates.
Conclusions:
- Toxic non-inflammatory fungal keratitis should be suspected in fungal ulcers with atypical inflammation following steroid therapy.
- Altered clinical signs warrant assessment for topical steroid misuse.
