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Post-LASIK Exophiala jeanselmei Keratitis.

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This case study describes Exophiala jeanselmei keratitis following laser eye surgery. Early antifungal treatment led to vision recovery, highlighting the importance of considering fungi in atypical keratitis cases.

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Area of Science:

  • Ophthalmology
  • Mycology

Background:

  • Laser in situ keratomileusis (LASIK) is a common refractive surgery.
  • Chronic topical corticosteroid use can predispose patients to ocular infections.

Observation:

  • A patient developed infectious keratitis after LASIK and prolonged topical steroid use.
  • Initial presentation in the left eye showed an atypical, dark-pigmented infiltrate.
  • The right eye later developed similar pigmented infiltrates.

Findings:

  • Cultures confirmed fungal infection, prompting early topical antifungal treatment.
  • Both eyes recovered good vision within approximately one month.
  • Dark pigmentation of corneal infiltrates was a key indicator of fungal etiology.

Implications:

  • Patients on chronic postoperative corticosteroids require vigilant monitoring for adverse effects.
  • Consider atypical organisms like fungi in infectious keratitis, especially if it appears late or has unusual features.
  • Recognizing dark pigmentation in corneal infiltrates can aid in diagnosing fungal keratitis.