European Journal of Cardiovascular Medicine

Background: Fungal keratitis is one of the most devastating microbial keratitis with the worst visual prognosis, potentially leading to blindness. The clinical characteristics of Fungal keratitis are mild pain, the insidious growth of fungal pathogens in the deep cornea, and difficult to differentiate it from other kinds of microbial keratitis early on. Therefore, the early and accurate diagnosis of Fungal keratitis by means of clinical features is sometimes impossible due to patients’ delayed visits or the great similarities of Fungal keratitis with other types of microbial keratitis in early stages of the disease. [3] Materials and methods: This is a prospective and observational study was conducted in the Department of Microbiology, SIMS over a period of 6 months. This includes 35 patients with clinically suspected fungal corneal ulcer within an age group of 15–60 years. Sociodemographic data, chief complain, history of present illness like onset, duration, associated features, aggravating or relieving factors were noted. Corneal scraping of the affected eye was collected under slit lamp illumination. The direct microscopy of 10% potassium hydroxide (KOH) wet mount and gram staining of the materials directly smeared on the slides were performed. The samples were also inoculated onto Sabouraud Dextrose Agar (SDA) plates for fungal culture at 27°C for 21 days. Result: Among the positive cases of fungal keratitis, males (65.7%) outnumbered females (34.3%) with the ratio of 1.67:1 (Table 1). The maximum number of positive cases were seen in age group of 21-30 years, followed by the age groups of 31-40 years and 11-20 years. The most common cause of Aspergillus fumigatus (28.6 %), Fusarium solani (20%), Cladophialophora bantiana and Candida tropicalis (14.3 % each), and Mucor and Candida albicans (5.7 % each), Curvularia (11.4%). Aspergillus species were found to be isolated from 50% of cases of keratomycosis.  Filamentous fungi were predominantly associated with mycotic keratitis, accounting for 71.4% of cases, as compared to yeasts which had caused keratitis in 28.6% of cases. Amongst the cases of keratomycosis (n=35), all were positive for fungal growth on culture, out of which 85.7% cases were also positive for the presence of fungal elements on direct microscopy. Conclusion: Fungal keratitis is often a severe disease in which diagnosis can be challenging, the response to medical treatment is slow, and the clinical outcome is poor. Corneal perforation is 5 to 6 times more likely with fungal keratitis than it is with bacterial keratitis. Because of serious consequences of infectious keratitis, it is important to know the exact aetiology of corneal ulcer to institute appropriate therapy in time