Symptoms: foreign body sensation, decreased vision, ocular pain, photophobia, red eye and watery discharge.
Signs:
Fine or coarse granular infiltrate within epithelium and anterior stroma
Gray-white color, dry, and rough corneal surface that may appear elevated
Typical irregular feathery-edged infiltrate
White ring in the cornea and satellite lesions near the edge of the primary focus of the infection
In advance cases: suppurative stromal keratitis associated with conjunctival hyperemia, anterior chamber inflammation, hypopion, iritis, endothelial plaque or possible corneal perforation.
Work Up
Corneal smears for yeasts, hyphae and pseudohyphae.
Cytologic, histologic examination, culture and corneal biopsy for diagnosis, confirmation and treatment purposes.
Management
Prolonged course of systemic and topical antifungal.
Frequent scraping or localized debridement to remove superficial corneal necrotic tissue.
Cycloplegic drop is indicated to reduce intraocular inflammation, relieve ciliary spasm and prevent posterior synechiae.
Anti-inflammatory agents and corticosteroids.
Surgical procedures such as superficial, lamellar keratectomy or penetrating keratoplasty are indicated when optimal anti-fungal therapy has failed to cure this infection.