Infectious crystalline keratopathy caused by Candida parapsilosis

Infectious crystalline keratopathy is a chronic infection of the cornea, characterized by branching intrastromal opacities without inflammation. These changes are usually due to accumulations of bacterial colonies, most commonly viridans streptococci, but this entity has previously been reported in association with Candida albicans and Candida tropicalis. We present the case of a 66-year-old man who had previously undergone penetrating keratoplasty and developed infectious crystalline keratopathy due to Candida parapsilosis. Histopathology showed interlamellar accumulations of viable yeasts with no inflammation. Chronic topical corticosteroid use in this patient produced relative immunosuppression, allowing for the infection by Candida parapsilosis and the lack of inflammation in the cornea. The spectrum of causative organisms in infectious crystalline keratopathy continues to grow, emphasizing the need for laboratory evaluation in the management of this disorder.