Summary about Disease
Fungal keratitis is an infection of the cornea (the clear front surface of the eye) caused by fungi. It is a serious condition that can lead to vision loss if left untreated. While relatively rare, it's more common in warm, humid climates and in individuals with specific risk factors, such as contact lens wear or eye injuries.
Symptoms
Eye pain
Redness
Blurry vision
Sensitivity to light (photophobia)
Excessive tearing
Feeling like something is in your eye (foreign body sensation)
White or gray lesion on the cornea
Causes
Eye injury, especially with plant matter: Trauma to the eye, particularly involving soil, twigs, or other organic material, is a major risk factor.
Contact lens wear: Improper contact lens hygiene, overnight wear, and contaminated lens solutions can increase the risk.
Compromised immune system: Individuals with weakened immune systems are more susceptible to fungal infections.
Chronic eye surface disease: Conditions like dry eye can make the cornea more vulnerable.
Topical steroid use: Prolonged use of steroid eye drops can suppress the immune system in the eye, increasing the risk.
Medicine Used
Antifungal eye drops: Natamycin 5% is a commonly used topical antifungal. Voriconazole 1% is another option.
Oral antifungal medications: Fluconazole, voriconazole, or posaconazole may be prescribed in severe cases or when topical treatment is insufficient.
In some cases: Corneal transplant might be considered if medication fails
Is Communicable
Fungal keratitis is generally not communicable from person to person. It is an opportunistic infection arising from fungal exposure in the environment, not through direct contact with an infected individual.
Precautions
Contact lens hygiene: Follow strict cleaning and disinfection protocols for contact lenses. Avoid overnight wear and use appropriate solutions.
Eye protection: Wear protective eyewear during activities that pose a risk of eye injury, such as gardening or construction work.
Prompt medical attention: Seek immediate medical care for any eye injury, especially those involving plant matter.
Avoid self-treatment: Do not use steroid eye drops without a doctor's prescription and close monitoring.
Good hygiene: Wash hands thoroughly and frequently, especially before touching your eyes or contact lenses.
How long does an outbreak last?
The duration of a fungal keratitis infection can vary significantly depending on the severity of the infection, the specific fungus involved, and the individual's response to treatment. Treatment can last for weeks to months. In severe cases, despite aggressive treatment, the infection may persist, leading to complications and potentially requiring surgical intervention.
How is it diagnosed?
Slit-lamp examination: An ophthalmologist uses a slit lamp to examine the cornea for signs of infection.
Corneal scraping: A small sample of corneal tissue is scraped and sent to a laboratory for microscopic examination and culture to identify the specific fungus.
Confocal microscopy: This imaging technique allows for non-invasive visualization of the cornea at a cellular level to detect fungal elements.
In vivo polymerase chain reaction (PCR): PCR is helpful to diagnose fungal keratitis
Timeline of Symptoms
The timeline of symptoms can vary.
Initial: Redness, pain, feeling of a foreign body
Days 2-7: Increase in pain, light sensitivity, blurred vision. Appearance of a corneal ulcer.
Weeks/Months If untreated symptoms will worsen and can lead to permanent vision loss
Important Considerations
Early diagnosis and treatment are crucial to prevent vision loss.
Fungal keratitis can be difficult to treat and may require prolonged therapy.
Compliance with medication regimens is essential for successful treatment.
Regular follow-up appointments with an ophthalmologist are necessary to monitor the infection and adjust treatment as needed.
Consider avoiding contact lens wear during treatment.