Corneal Fungal Keratomycosis - A Therapeutic Challenge: A Case Report

Objective: To report a case of fungal keratitis caused by Fusarium species. Result: A 57 year old man presented with painful blurring of vision of his left eye. There was presence of dry corneal ulcer with irregular borders, hypopyon and anterior chamber cell activity. An initial diagnosis of bacterial keratitis was made and was started on topical ceftazidime and topical ciprofloxacin. When corneal scraping revealed hyphae the diagnosis was revised to fungal keratitis and he was started on topical amphotericin B 0.15%. He developed corneal toxicity due to amphotericin B and antifungal was changed to topical fluconazole 5%. His ulcer slowly healed with a final visual acuity of 6/36. Conclusion: Treatment of fungal keratitis remains a challenge and the use of topical anti fungal remains a mainstay. However the side effects of corneal toxicity secondary to the medications also needs to be given importance.