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What is Fungal Keratitis?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 30 November 2016
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With keratitis, the cornea becomes irritated and swollen. This can happen due to a number of causes. One potential cause is infection via a fungus (yeast or mold). If a fungal infection results in keratitis, this condition is called fungal keratitis. The condition requires treatment so the inflammation of the cornea is brought under control.

A person might not know if they have fungal keratitis, or keratitis caused by bacteria. In fact, it is not easy to diagnose, even upon examination by an ophthalmologist. Signs of fungal keratitis usually start with red or irritated eyelids, and then progresses to additional symptoms. These can include burning of the eyes or repeated itching.

Some people note excess tearing or watering of a single eye, which is also bloodshot. It may be possible to see a white dot on the cornea (though not always). Tolerating light gets more difficult and many have photosensitivity. In general people might notice a reduction in ability to see things. Another feature of fungal keratitis is pain in the eyes, which can be significant.

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There are a few ways that fungal keratitis is likely to occur. Direct contact with plant matter to the eye, such as getting hit with a branch, might transfer certain forms of fungus to the eye, which then begins to grow. In the mid 2000s, there was a sharp increase in fungal keratitis cases due to people using a contaminated contact lens. When the problem was discovered the lenses were removed from the market. Contact lens users do seem in general more at risk for getting this condition, but ability for fungus to build in the eye may also be more likely in people who have suppressed immune systems. However, sometimes the condition occurs in people in excellent health.

It is extremely important that people with keratitis see an ophthalmologist for diagnosis. Whether the condition is fungal keratitis or of bacterial origin, it needs to be treated to protect the cornea. Doctors may take a tiny swab at the eye to confirm the presence of bacteria or fungi. Those these conditions are related, they can’t be treated in the same manner. Adding anti-bacterial eyedrops to an eye infected with fungus is likely to make the problem worse. So essentially, doctors will want to confirm the agent creating keratitis before offering treatment.

Treatment is often in the form of anti-fungal eye drops. For very severe cases, oral anti-fungal medications might be considered instead, though they are not thought as effective. As treatment progresses, people are usually warned to not touch the eyes any more than is necessary to prevent fungal keratitis from spreading. Handwashing after each hand to eye contact is strongly advocated. Contact lens wearers may need to forgo wearing lenses while treatment is underway, and they might need to replace current lenses so the infection doesn’t restart after it has been treated.

Successfully treating fungal keratitis treatment can be a long and difficult process. In addition to daily eye drops, several medications may be required to get the infection under control.

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