Fungal keratitis in Germany : Diagnostics, conservative and microsurgical treatment

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Fungal keratitis is a rare but severe ocular infection with significant vision-threatening potential.
• It is frequently misdiagnosed initially, similar to acanthamoeba keratitis.
• An increasing incidence of fungal keratitis has been noted globally, including Germany, potentially linked to soft contact lens use and climate change.

Purpose of the Study:

• To provide a comprehensive overview of fungal keratitis.
• To discuss current diagnostic methods and treatment strategies, including medical and microsurgical options.
• To highlight the indications, techniques, and postoperative care for emergency keratoplasty in fungal keratitis.

Main Methods:

• Review of clinical signs and symptoms of keratomycosis.
• Analysis of recent advancements in diagnostics.
• Evaluation of drug therapy and microsurgical interventions.
• Detailed examination of emergency keratoplasty (à chaud) procedures.

Main Results:

• Fungal keratitis presents with specific, though often initially missed, clinical signs.
• Advanced diagnostic tools improve detection rates.
• A combination of antifungal therapy and surgical intervention, including keratoplasty, is often necessary.
• Emergency keratoplasty can be a vital sight-saving procedure.

Conclusions:

• Fungal keratitis requires high clinical suspicion due to its potential for severe visual impairment.
• Prompt and accurate diagnosis is critical for effective management.
• Integrated treatment approaches combining medical and surgical interventions, especially emergency keratoplasty, are essential for managing severe cases.