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Mycotic keratitis--an underestimated mycosis
1Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli, India.
Summary
Mycotic keratitis, an eye infection common in tropical outdoor workers, is caused by various fungi. Early diagnosis and prompt antifungal treatment are crucial for managing this serious ophthalmologic condition.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Mycotic keratitis is a significant eye infection, particularly affecting outdoor workers in tropical regions.
- Common causative agents include filamentous fungi (e.g., Fusarium, Aspergillus, Curvularia) and yeast-like fungi (e.g., Candida).
Purpose of the Study:
- To outline the diagnostic approaches and therapeutic strategies for mycotic keratitis.
- To discuss the pathogenesis and identify areas for future research in managing fungal eye infections.
Main Methods:
- Diagnosis involves clinical recognition, microscopic examination of corneal scrapings, and fungal cultures.
- Advanced methods like corneal biopsies, histopathology, and fluorescein-conjugated lectins aid in difficult cases.
- Antifungal susceptibility testing guides treatment selection.
Main Results:
- Prompt diagnosis and initiation of antifungal therapy are essential.
- While many fungal keratitis cases respond to polyenes and azoles, Fusarium keratitis often requires specific agents like pimaricin or econazole.
- Severe cases may necessitate oral/parenteral antifungals or surgical intervention.
Conclusions:
- Effective management of mycotic keratitis relies on accurate diagnosis and timely, appropriate antifungal treatment.
- Understanding the interplay of fungal and host factors is key to pathogenesis.
- Future research should focus on rapid diagnostics, broad-spectrum antifungals, and novel therapeutic approaches.