Fungal Keratitis (Fungal Infection of the Cornea)

What is fungal keratitis?

Fungal keratitis is an infection of the cornea (the clear outer layer of the eye). It can cause a breakdown of the cornea, which is called a corneal ulcer. The ulcer can cause swelling and cloudiness of the cornea and a decrease in your vision.

How does it occur?

The types of fungi that cause fungal keratitis are found in our everyday environment and include:

• Aspergillus
• Fusarium
• Candida (yeast)

These fungi cannot usually infect a healthy cornea. However when there are tiny breaks in the outermost layer of the cornea (the epithelium), these fungi can reach the cornea and cause an infection.

Anything that causes a break or scratch in the cornea can lead to a fungal infection, but you have a greater risk if you get a scratch on your eye from any plant matter. Improper use of contact lenses, such as failing to clean your contacts properly or sleeping in your contacts, can also increase the risk of a fungal infection.

What are the symptoms?

Symptoms of fungal keratitis include:

• gritty feeling
• watery eyes
• decreased or cloudy vision
• light sensitivity (photophobia)
• redness and irritation of the eye

How is it diagnosed?

Your healthcare provider will ask about your symptoms, examine your eyes, and perform tests to identify the cause. Tests you may have are:

• an exam using a special microscope (a slit lamp) to look closely at your cornea
• an exam with drops and special lenses to look into the back of your eye (a dilated exam)
• tests of your cornea to look for the cause of your infection under a microscope
• an ultrasound test to look at the back of your eye if you have a severe infection

How is it treated?

Fungal keratitis is a very severe condition and can be hard to treat. Your healthcare provider may first treat you for a bacterial infection with antibiotic drops. This is because it can take several days for tests to show what is causing the infection. After the diagnosis of fungal keratitis is made, your healthcare provider will give you drops that treat fungal infections and may ask you to use these every couple of hours, even during the night. You may also be given anti-fungal pills to take by mouth.

How long will the effects last?

If not treated right away, fungal keratitis can cause blindness. The treatment of fungal keratitis will require frequent trips to your eye healthcare provider to make sure that the infection is getting better.

Fungal keratitis can lead to a permanent scar even after successful treatment. If this scar limits your vision, your healthcare provider may recommend several options including a contact lens, laser treatment or surgery.

How can I take care of myself?

If you have any of the symptoms of a fungal infection after getting something in your eye, or if you wear contact lenses, you should contact your healthcare provider right away. If you are given drops to use, be sure to follow your healthcare provider's instructions carefully and keep all of your follow-up appointments.

How can I prevent fungal keratitis?

• If you wear contact lenses, wash your hands before handling them, clean your contacts as instructed and do not sleep in your lenses.
• If you work in a place where things may get into your eye, be sure to wear goggles at all times.