Fungal Keratitis: Diagnosis, Management, and Recent Advances

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Fungal keratitis is a significant cause of microbial keratitis and potential corneal blindness.
• Challenges in fungal keratitis include diagnostic difficulties and limitations in antifungal medication efficacy and availability.
• Current treatments often require intensive and prolonged antifungal therapy.

Purpose of the Study:

• To review the current understanding and management strategies for fungal keratitis.
• To highlight the complexities in diagnosis and treatment of fungal eye infections.
• To explore various therapeutic modalities, including medical, surgical, and emerging treatments.

Main Methods:

• Literature review of fungal keratitis diagnosis and treatment.
• Analysis of conventional and alternative therapeutic approaches.
• Discussion of challenges in laboratory diagnosis and drug efficacy.

Main Results:

• Antifungal medications are the primary treatment, with topical application being a mainstay, supplemented by systemic, intrastromal, or intracameral routes.
• Therapeutic keratoplasty is a key surgical intervention for severe cases.
• Intrastromal and intracameral injections offer potential for sustained drug levels, while collagen cross-linking is an emerging adjunctive therapy requiring protocol optimization.

Conclusions:

• Fungal keratitis management requires a multi-faceted approach combining appropriate antifungal therapy with surgical interventions when necessary.
• Further research is needed to optimize novel treatments like collagen cross-linking for improved microbial killing and clinical outcomes.
• Addressing diagnostic challenges and enhancing antifungal drug delivery are crucial for better patient prognosis.