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Fungal keratitis

fungal keratitis introduction , pathogenesis , treatment , diagnosis .

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Fungal keratitis

  1. 1. Sushant shah 2nd year Bsc. optometry Nethradhama college of optometry Fungal Keratitis
  2. 2. FUNGAL KERATITIS OR KERATOMYCOSIS
  3. 3. Introduction A fungal keratitis is an 'inflammation of the eye's cornea' (called keratitis) that results from infection by a fungal organism. One of the major cause of infectious keratitis in tropical countries • Typically seen after injury with vegetable matter , use of contact lens
  4. 4. Predisposing factors injury with vegetable matter
  5. 5. Predisposing factors contd.. • use of contact lens
  6. 6. Causative organisms  Hyaline Filamentous fungi – Aspergillus , Penicillum , Fusarium Dematiacious filmentous fungi - Culvularia, Cladosporium Yeast – Candida albicans
  7. 7. Epidemiology Aspergillus species is the most common organism responsible for fungul keratitis world wide . Aspergillus: 27-64 % Fusarium: 6-32 % Penicillum: 2-29 %
  8. 8. Pathogenesis
  9. 9. Clinical features • Slow progression • Signs more & Symptoms less Symptoms • Defective vision • Photophobia • Watering • Marked ciliary & conjunctival congestion
  10. 10.  Signs • Corneal ulcer • Dry looking ulcer with irregular border • Satellite lesions around ulcer • Hypopyon – thick & immobile • Wesseley ring – deposition of immune complexes & inflammatory cells Clinical features contd..
  11. 11. Wesseley ring Hypopyon
  12. 12. Diagnosis • Careful clinical evaluation correlating typical history, symptoms and signs • Culture of corneal scrapping • USG – endophthalmitis – exudates in the vitreous
  13. 13. Suggested Lab Workup  KOH wet mount with or without stain .  Gram staining.  LCB  Culture in SDA(sabooraud's dextrose agar) and blood agar
  14. 14. Treatment  Medical Filamentous fungi – Natamycin Amphoterecin B Miconazole ointment Yeast – Nystatin
  15. 15.  Surgical •Corneal graft •Covered with conjunctival flap

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