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Post-LASIK Exophiala jeanselmei Keratitis
Adil Ahmed1, Ali Mahdavi Fard, Hugo Y Hsu
1Doheny Eye Center of UCLA (A.A., H.Y.H.), Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Loma Linda University Medical Center (A.M.F.), Department of Ophthalmology, Loma Linda, CA.
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.
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.
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