Fungal Keratitis

PubMed ID: 29630244

Author(s): Castano G, Elnahry AG, Mada PK. Fungal Keratitis. 2024 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK493192/ PMID 29630244

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Microbial keratitis can arise from various sources, including bacteria, viruses, fungi, and protozoa. Among these, fungal keratitis (FK) is a significant contributor. Its historical documentation dates back to 1879, and its incidence has increased over the last 30 years. It accounts for 40% to 50% of all microbial keratitis cases. Fungal keratitis is a serious condition that demands prompt and effective intervention. Neglecting proper treatment can result in corneal destruction and endophthalmitis, leading to profound vision loss. Early diagnosis and management are essential to prevent long-term complications, including blindness. Over 100 fungal species have been identified as potential culprits behind fungal keratitis. The predominant fungal strain responsible for these infections may exhibit variation based on geographical regions. Approximately 40% of fungal infections are secondary to trauma. Monomorphic fungi can be classified into yeast and filamentous fungi, both of which play a role in the occurrence of fungal keratitis. The specific type of fungal variant responsible for fungal keratitis depends on several factors, including individual susceptibility, regional temperature patterns, climate conditions, geographic location, and the degree of urbanization. Fungal keratitis is notably linked to a spectrum of personal risk factors, with trauma, immunocompromised state, ocular surface disease, and contact lens usage as the most prevalent contributors. These factors not only elevate the risk of fungal keratitis but also might predispose individuals to diverse types of fungal infections, emphasizing the multifaceted nature of this condition. Diagnosing fungal infections as the source of keratitis can be challenging in clinical settings, often leading to delays in confirming through culture results. This makes it crucial to strongly consider the possibility of fungal keratitis, especially when specific risk factors are present. Even after diagnosis, managing the condition is challenging because many antifungal medications struggle to penetrate the cornea effectively.