Fungal Keratitis

Fungal keratitis is an infection of the clear front window of the eye (the cornea) caused by a fungus. The cornea helps focus light onto the retina, allowing us to see clearly. When fungi invade the cornea, they can cause pain, redness, blurred vision, and even permanent vision loss if not treated promptly. Fungal keratitis tends to develop more slowly than bacterial keratitis, often over days to weeks, but it can become severe quickly if ignored. Understanding the details of fungal keratitis—including its types, causes, symptoms, and diagnostic tests—is essential for early detection and effective treatment.

Fungal keratitis, or keratomycosis, is an infection of the cornea—the clear “window” at the front of your eye—caused by fungi such as Fusarium, Aspergillus, and Candida species. It often follows minor corneal injury (especially involving plant matter) or improper contact‐lens use, allowing fungal spores to invade and multiply in the corneal tissue. This infection typically develops more slowly than bacterial keratitis, with symptoms that can include eye pain, redness, blurred vision, sensitivity to light, tearing, and sometimes discharge WikipediaAAO. If not diagnosed and treated promptly, fungal keratitis can lead to corneal scarring, vision loss, or even perforation of the eye EyeWiki.

Fungi are tiny organisms present in soil, water, plants, and decaying matter. When spores or fragments of fungi enter the eye—often through an injury or by contact lens misuse—they can multiply in the corneal tissue. Because fungi thrive in warm, moist environments, fungal keratitis is more common in tropical or subtropical climates, though it can occur anywhere. People working in agriculture, gardening, or other outdoor activities may be at higher risk, especially if they suffer an eye injury involving plant material. Contact lens wearers who do not follow proper hygiene practices also face a significant risk.

This guide uses very simple English, avoids medical jargon, and explains every term in detail. Each section is written in paragraph form for clear reading and is search-engine optimized with natural keywords—such as “fungal keratitis,” “corneal infection,” “symptoms of fungal keratitis,” and “diagnostic tests for eye infections”—to help learners and patients find reliable information. Throughout, each keyword and concept is described in straightforward language with evidence-based accuracy.

Fungal keratitis makes up about 5–30% of all corneal infections in developed countries and over 50% in tropical regions, reflecting the role of climate and environmental exposure. Studies show that up to 40% of eye infections in agricultural workers in South Asia are fungal in origin, driven by trauma from plant material contaminated with fungus. Seasonal patterns may occur, with more cases in monsoon or rainy seasons when humidity is high. Overall, fungal keratitis remains underdiagnosed in many areas because its symptoms can mimic bacterial infections early on. Watching for the specific signs and risk factors described below helps doctors identify fungal cases more reliably.

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Pathophysiology: How Fungal Keratitis Develops

When fungal spores land on the cornea, they stick to the surface cells using sticky molecules on their outer coating. If the corneal surface has been scratched or damaged—by a tree branch, dust particle, or poorly fitted contact lens—the spores find an entry point beneath the protective cell layer. Once inside, fungal cells germinate, sending out root-like structures called hyphae. These hyphae burrow deeper into the corneal tissue, feeding on cells and releasing enzymes that break down proteins.

The body’s first defense is the tear film, which contains antimicrobial proteins and immune cells. Tears wash away many spores, but if the tear layer is disrupted, fungi can multiply. Immune cells called neutrophils arrive to fight the invaders, creating inflammation (redness and swelling). However, the inflammation itself can damage corneal clarity. Over time, fungal hyphae form networks that spread the infection, creating a white or gray patch on the cornea. If left unchecked, the infection can reach the deep layers of the cornea, potentially entering the eye’s interior and causing vision-threatening complications like endophthalmitis.

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Types of Fungal Keratitis

Fungal keratitis falls into two broad groups based on the fungus’s shape: filamentous (mold-like) and yeast-like (single-celled). Each group includes several species that commonly infect the cornea.

1. Filamentous (Mold-Like) Fungi

Filamentous fungi grow as long, branching threads called hyphae. These hyphae intertwine to form a mat or network, which can be seen under a microscope. Filamentous fungi are the most common cause of fungal keratitis in warm, humid climates and after injuries involving plant matter.

• Fusarium species
  Description: Fusarium is a soil-dwelling fungus found on plants and in water. Under the microscope, it appears as smooth, slender hyphae with spindle-shaped spores.
  Why it infects: Fusarium spores stick to tiny scratches on the cornea. They germinate into hyphae that invade corneal tissue.
  Significance: Fusarium keratitis often follows trauma with plant material or exposure to contaminated water. It may respond slowly to treatment and can cause deep corneal ulcers if untreated.

• Aspergillus species
  Description: Aspergillus fungi form dense, bushy clusters of hyphae with round spore heads. They thrive in compost, dust, and decaying vegetation.
  Why it infects: Tiny spores float in air and land on the eye, especially when corneal defenses are weak from injury or lens wear.
  Significance: Aspergillus keratitis can cause a greyish-white infiltrate in the cornea and sometimes pigment release. It may require combined antifungal therapy for effective control.

• Curvularia and Bipolaris species
  Description: These fungi have curved, multicelled spores and are commonly found in grass and soil. They appear as multi-septate (segmented) hyphae under the microscope.
  Why it infects: Injury with grass or straw can deposit spores directly into the cornea.
  Significance: Curvularia and Bipolaris infections often cause dark pigmented lesions in the cornea. They usually respond well to topical antifungal drops if caught early.

• Mucorales group (e.g., Mucor, Rhizopus)
  Description: These fungi grow very rapidly, producing wide, ribbon-like hyphae. They inhabit decaying vegetation and soil.
  Why it infects: Rarely causes keratitis, but when spores enter a damaged eye, the infection spreads quickly.
  Significance: Mucorales keratitis is aggressive, often affecting deeper structures and sometimes requiring surgical removal of infected tissue.

2. Yeast-Like Fungi

Yeasts are single-celled fungi that reproduce by budding. Under the microscope, they appear as round or oval cells. Candida is the main yeast causing corneal infections, often following eye surgery or in people with weakened immune defenses.

• Candida albicans and non-albicans species
  Description: Candida species form white colonies on culture media and appear as budding yeast cells. Some species also form short hyphae called pseudohyphae.
  Why it infects: Candida thrives on moist surfaces and can contaminate contact lenses or surgical instruments.
  Significance: Candida keratitis often develops slowly, presenting with a fluffy white lesion. It responds well to antifungal drops but may recur if risk factors persist.

• Cryptococcus neoformans
  Description: Cryptococcus has a thick, sugar-based capsule that stains with special dyes. It grows as round yeast cells.
  Why it infects: Rare in healthy eyes, but can infect immunocompromised patients, especially after surgery.
  Significance: Cryptococcal keratitis can present with gelatinous patches on the cornea. It requires systemic antifungal therapy in addition to topical drops.

• Other yeast species (e.g., Rhodotorula)
  Description: Rare causes of keratitis; appear as pigmented yeast cells on culture.
  Why it infects: Usually associated with contaminated contact lens solutions or ocular surgeries.
  Significance: These infections are uncommon and may need tailored therapy based on species identification.

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Causes of Fungal Keratitis

Each of the following twenty situations can set the stage for fungi to invade the cornea. Understanding these causes helps prevent infection.

1. Corneal Trauma with Plant Material
   After a stick, branch, or leaf scratches the cornea, fungal spores on the plant can enter and begin to grow. Even a tiny scratch from grass can introduce enough spores for infection.

2. Contact Lens Overwear
   Sleeping in contact lenses or wearing them too long reduces oxygen to the cornea and traps debris against the eye, providing a moist environment where fungi can grow.

3. Improper Lens Cleaning
   Using homemade saline, tap water, or expired solutions to clean lenses can introduce fungal spores, which then remain on the lens surface and infect the eye when worn.

4. Extended Use of Corticosteroid Eye Drops
   Steroid drops suppress local immunity on the eye surface, making it easier for fungi to survive and multiply if they land on the cornea.

5. Underlying Ocular Surface Disease
   Conditions such as dry eye, blepharitis (eyelid inflammation), or corneal dystrophies weaken the natural protective barrier of the eye, allowing fungal entry.

6. Recent Ocular Surgery
   Procedures like corneal transplants, LASIK, or cataract removal can leave tiny wounds where fungi may gain access if sterile technique fails or patient hygiene is poor afterward.

7. Use of Traditional Eye Medicines
   In some regions, unsterilized herbal or animal-based eye drops introduce fungal spores directly onto the cornea.

8. Agricultural Work
   Farming tasks involving soil, manure, or decaying plant matter expose workers to high fungal spore loads that can contact the eye during bending or harvesting.

9. Living in Tropical or Subtropical Climates
   Warm, humid environments promote fungal growth in soil and organic debris, increasing environmental spore counts that can land on the eye.

10. Poor Personal Hygiene
    Failing to wash hands before touching the eyes or contact lenses can transfer fungal spores from contaminated surfaces to the cornea.

11. Chronic Lid Lacerations or Scars
    Old injuries that change eyelid shape can prevent normal blinking and tear distribution, creating dry patches where fungi adhere.

12. Immune System Disorders
    Diabetes, HIV/AIDS, or systemic immunosuppressive therapy reduce the body’s overall ability to fight off corneal infections.

13. Use of Topical Anesthetics
    Anesthetic drops can mask early pain from corneal injury, delaying diagnosis while fungi multiply unchecked.

14. Eye Exposure to Contaminated Water
    Swimming in ponds, rivers, or hot tubs without goggles can splash fungal spores onto the cornea.

15. Occupational Exposure to Dust
    Construction or mining work raises dust containing spores of Aspergillus or Fusarium that can contact the eye.

16. Malnutrition and Vitamin A Deficiency
    Poor diets weaken mucous membranes and reduce tear production, impairing barrier function against pathogens.

17. Use of Chemotherapeutic Agents
    Certain cancer drugs reduce white blood cell counts, including those in tears, making fungal invasion easier.

18. Chronic Use of Systemic Antibiotics
    Long courses of broad-spectrum antibiotics shift normal eye surface flora, allowing fungi to overgrow without competition.

19. Anesthetic or Ocular Surface Toxicity
    Repeated use of preservatives in eye drops can irritate and damage corneal cells, creating microabrasions where fungi enter.

20. Previous Herpes Simplex Keratitis
    Viral damage to the cornea and its nerves alters healing and reduces tear production, increasing vulnerability to secondary fungal infection.

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Symptoms of Fungal Keratitis

Fungal keratitis often begins gradually but can worsen rapidly. These fifteen symptoms help recognize the infection:

1. Eye Redness
   The white part of the eye (sclera) looks red or pink because blood vessels dilate as part of the body’s defense response.

2. Eye Pain or Discomfort
   Patients may feel a dull ache or sharp pain, especially when blinking, due to corneal nerve irritation.

3. Foreign Body Sensation
   A feeling of grit, sand, or a small object constantly rubbing on the eye surface.

4. Tearing or Watery Eyes
   Excess tear production attempts to flush out invading organisms and soothe the irritated surface.

5. Discharge from the Eye
   A stringy or mucoid discharge may be present; sometimes it is thick and white.

6. Blurred or Reduced Vision
   As the cornea becomes cloudy from inflammation and fungal growth, vision may become hazy or significantly reduced.

7. Light Sensitivity (Photophobia)
   Bright lights or sunlight cause discomfort or pain because the inflamed cornea transmits pain signals when exposed.

8. Corneal Opacity or White Spot
   A visible white, gray, or yellow patch on the cornea indicates a localized area of fungal growth and inflammation.

9. Corneal Ulceration
   In severe cases, an open sore develops on the cornea, visible as a crater or pit.

10. Swollen Eyelids
    Inflammation can extend to the eyelids, causing puffiness and difficulty fully opening the eye.

11. Delayed Healing of Corneal Abrasions
    Simple scratches that normally heal in days may persist or worsen when fungi are present.

12. Haloes or Colored Rings Around Lights
    Swelling of the cornea changes how light bends, creating rainbow-colored rings, especially in dim settings.

13. Mucus Threading
    Fine strands of mucus can stretch between the eyelids and cornea when blinking.

14. White Spots on Contact Lenses
    For lens wearers, deposits or spots may adhere to or form on the lens surface, hinting at contamination.

15. Reduced Tear Film Break-Up Time
    Tears evaporate quickly, leading to dryness because the corneal surface is irregular from fungal invasion.

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Diagnostic Tests for Fungal Keratitis

Accurate diagnosis requires a combination of clinical examination and laboratory tests. Below are twenty tests, grouped by category, each explained in very simple terms.

A. Physical Examination

1. Slit-Lamp Biomicroscopy
   A specialized microscope with a bright, thin beam of light allows the eye doctor to look at the cornea’s layers in detail. Redness, ulcer size, and depth of the infection are assessed.

2. Fluorescein Staining
   A yellow dye called fluorescein is placed in the eye. Under blue light, scratches or ulcers glow green, helping locate infected areas.

3. Visual Acuity Test
   Reading letters on a chart measures how well you can see. Reduced acuity may indicate corneal clouding from infection.

4. Pupillary Light Reflex
   Shining a light into the eye checks if the pupil responds normally. Abnormal reactions may suggest deeper eye involvement.

5. Eyelid and Tear Duct Inspection
   Doctors examine eyelids and tear drainage tubes for swelling, blockages, or debris that could harbor fungi.

B. Manual Tests

6. Corneal Scrapings
   Under numbing drops, the doctor gently scrapes cells from the ulcer’s edge with a sterile spatula. These cells contain any fungi present.

7. Conjunctival Impression Cytology
   A special filter paper touches the eye surface, picking up surface cells for fungus detection without scraping.

8. Contact Lens Culture
   If a contact lens is worn, it is sent to the lab to see if fungi grow on its surface.

9. Tear Film Sample
   Tears are collected with a capillary tube to test for fungal DNA or proteins.

10. Eyelid Swab
    A cotton swab wipes the eyelid margin to see if fungi are present on the skin near the cornea.

C. Laboratory and Pathological Tests

11. Gram Stain
    A common stain that colors bacteria and some fungi, providing a quick look under the microscope. Fungal cells often appear large and irregular.

12. KOH (Potassium Hydroxide) Preparation
    A drop of KOH solution on scraped cells dissolves human cells but leaves fungal filaments intact, making them easier to see under the microscope.

13. Calcofluor White Staining
    A fluorescent dye that binds to fungal cell walls, causing them to glow under ultraviolet light for clear identification.

14. Fungal Culture on Sabouraud Agar
    Scraped cells are placed on a special jelly-like medium that encourages fungal growth. Identification takes days to weeks based on colony appearance.

15. PCR (Polymerase Chain Reaction) for Fungal DNA
    This molecular test copies and detects tiny amounts of fungal genetic material in corneal scrapings, giving a fast and precise species identification.

D. Electrodiagnostic Tests

16. Corneal Nerve Function Test (CFF: Corneal Fluorescence Function)
    Measures how the corneal nerves respond to light and touch. Reduced function may indicate deep corneal involvement.

17. Blink Reflex Measurement
    Electrodes detect electrical signals when the eyelid blinks in response to a gentle air puff, assessing nerve health affected by infection.

18. Tear Film Osmolarity
    A small device measures salt concentration in tears, helping understand tear film disruption from corneal damage.

E. Imaging Tests

19. Anterior Segment Optical Coherence Tomography (AS-OCT)
    A noncontact imaging scan produces a cross-sectional picture of the cornea, showing ulcer depth and fluid pockets.

20. In Vivo Confocal Microscopy
    A high-resolution imaging technique that magnifies living corneal cells, allowing direct visualization of fungal filaments within the cornea.

Non‐Pharmacological Treatments

Below are 20 physical or procedural therapies—excluding antifungal drugs—that support corneal healing, reduce fungal load, or improve drug penetration. Each has its own purpose and working mechanism:

1. Contact‐Lens Removal and Disinfection
   Immediately removing lenses stops continual fungal inoculation and allows the cornea to heal; disinfecting lenses and cases eliminates residual spores PMC.

2. Protective Eye Shield
   A plastic shield guards the eye from further trauma and reduces blinking‐related irritation, promoting a stable healing environment Medscape.

3. Corneal Epithelial Debridement
   Gently scraping away infected superficial tissue increases antifungal penetration and lowers microbial load MedscapePMC.

4. Repeat Debridement
   In stubborn cases, serial scraping further exposes deep fungal filaments to topical therapy, enhancing drug efficacy Medscape.

5. Photodynamic Antimicrobial Therapy (PDAT-RB)
   Applying rose bengal dye followed by green light generates reactive oxygen species that kill fungi directly, useful for resistant ulcers PMC.

6. Collagen Cross-Linking (CXL)
   Riboflavin plus UV-A strengthens corneal collagen, creating an environment less hospitable to fungal growth and enhancing structural integrity PMC.

7. Amniotic Membrane Transplantation (AMT)
   A thin layer of donor amniotic membrane placed on the cornea supplies growth factors, reduces inflammation, and promotes epithelial repair PubMed.

8. Debulking Corneal Biopsy
   Partial surgical removal of infected tissue both lowers fungal burden and provides diagnostic material for culture and microscopy Nature.

9. Tarsorrhaphy
   Partially sewing eyelids together reduces exposure, maintains moisture, and aids healing in large epithelial defects Medscape.

10. Bandage Soft Contact Lens
    A therapeutic lens shields the cornea, relieves pain, and supports re-epithelialization after debridement Medscape.

11. Warm Compresses
    Applying gentle warmth increases blood flow and immune cell access to the ocular surface, aiding fungal clearance Medscape.

12. Cold Compresses
    Brief cold applications can reduce pain and photophobia by calming ocular surface nerves Medscape.

13. Lubricating Artificial Tears
    Preservative-free tears maintain hydration, protect exposed nerve endings, and improve comfort Medscape.

14. Avoidance of Topical Steroids
    Steroids worsen fungal growth; withholding them until infection is controlled prevents exacerbation Medscape.

15. Environmental Hygiene
    Keeping living spaces free of mold and avoiding contaminated water (e.g., well water for lens cleaning) reduces reinfection risk PMC.

16. Patient Education
    Teaching proper lens care, hygiene, and signs of worsening ensures timely treatment and better outcomes Medscape.

17. Limiting Screen Time
    Reducing eye strain and blinking helps maintain a stable tear film and speeds healing Medscape.

18. Nutritional Support
    A balanced diet (see below) strengthens overall immunity and supports corneal repair PMC.

19. Adequate Rest
    Systemic rest supports immune function, allowing the body to fight infection more effectively Medscape.

20. Sunlight Protection
    Wearing sunglasses shields the healing cornea from UV damage and glare, preserving tissue integrity Medscape.

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Drug Treatments

These antifungal agents are cornerstones in fungal keratitis management. (Class · Common Dosage · Timing · Purpose · Mechanism · Main Side Effects)

1. Natamycin 5% Suspension (Polyene)
   – Dosage: 1 drop hourly for 1 week, then taper over 6–8 weeks
   – Purpose: First-line for filamentous fungi (e.g., Fusarium)
   – Mechanism: Binds ergosterol in fungal cell membranes, causing cell death
   – Side Effects: Eye irritation, corneal haze MedscapePMC

2. Amphotericin B 0.15–0.2% Drops (Polyene)
   – Dosage: 1–2 drops every hour, tapered over 4–12 weeks
   – Purpose: First-line for yeasts (e.g., Candida)
   – Mechanism: Pore formation in ergosterol-rich membranes
   – Side Effects: Epithelial toxicity, pain PMCMedscape

3. Voriconazole 1% Eye Drops (Triazole)
   – Dosage: 1 drop hourly, then taper to 4–6 times/day over 8–12 weeks
   – Purpose: Alternative for resistant Aspergillus and Fusarium
   – Mechanism: Inhibits fungal ergosterol synthesis
   – Side Effects: Dry eye, transient vision changes MedscapePubMed

4. Fluconazole 0.2% Eye Drops (Triazole)
   – Dosage: 1 drop every 2 hours, tapered over 4–8 weeks
   – Purpose: Adjunct for yeast keratitis
   – Mechanism: Blocks ergosterol synthesis
   – Side Effects: Ocular burning MedscapePMC

5. Itraconazole Oral 200 mg Daily (Triazole)
   – Dosage: 200 mg once daily for 4–6 weeks
   – Purpose: Deep stromal involvement or adjunct therapy
   – Mechanism: Ergosterol synthesis inhibition
   – Side Effects: Gastrointestinal upset, liver enzyme elevation MedscapePMC

6. Ketoconazole Oral 200 mg Twice Daily (Imidazole)
   – Dosage: 200 mg BID for 4–6 weeks
   – Purpose: Adjunct in deep infections
   – Mechanism: Ergosterol pathway inhibition
   – Side Effects: Hepatotoxicity, hormonal effects MedscapePMC

7. Micafungin 0.1% Drops (Echinocandin)
   – Dosage: 1 drop hourly, tapered over 4–8 weeks
   – Purpose: Alternative for Candida species
   – Mechanism: Inhibits β-glucan synthesis in fungal cell walls
   – Side Effects: Conjunctival irritation MedscapePMC

8. Flucytosine Oral 25 mg/kg QID (Pyrimidine Analog)
   – Dosage: 25 mg/kg four times daily
   – Purpose: Synergistic with polyenes or azoles
   – Mechanism: Blocks fungal DNA/RNA synthesis
   – Side Effects: Bone marrow suppression, GI upset MedscapePubMed

9. Econazole 1% Drops (Imidazole)
   – Dosage: 1 drop every 1–2 hours for 2 weeks, then taper
   – Purpose: Fusarium and other filamentous fungi
   – Mechanism: Ergosterol synthesis inhibition
   – Side Effects: Burning, stinging PMC

10. Intrastromal Voriconazole 50 μg/0.1 mL
    – Dosage: Injection into stromal lesion once or repeated weekly
    – Purpose: Deep, recalcitrant ulcers
    – Mechanism: High local drug concentration inhibits ergosterol
    – Side Effects: Hypopyon increase, transient pain PubMedDove Medical Press

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Dietary Molecular Supplements

These nutrients support immunity and corneal repair:

1. Vitamin A (1,000–5,000 IU/day) for epithelial maintenance PMC

2. Vitamin C (500 mg BID) for collagen synthesis and antioxidant protection PMC

3. Vitamin E (400 IU/day) as an ocular surface antioxidant PMC

4. Zinc (15–30 mg/day) to support wound healing PMC

5. Omega-3 Fatty Acids (1,000 mg EPA/DHA daily) to reduce inflammation PMC

6. Selenium (100 μg/day) for antioxidant enzyme function PMC

7. Curcumin (500 mg BID) for anti‐inflammatory and antifungal effects PMC

8. Quercetin (500 mg BID) for anti‐oxidative and modulatory roles PMC

9. Lutein/Zeaxanthin (10 mg/2 mg daily) to protect ocular tissues PMC

10. Probiotics (e.g., Lactobacillus) to support systemic immunity PMC

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Regenerative/Stem-Cell–Related Drugs

Emerging therapies that promote corneal healing:

1. Autologous Serum Eye Drops (20% dilution, 5–10×/day)
   – Rich in growth factors and vitamins to accelerate epithelial healing PMC.

2. Platelet-Rich Plasma Drops (PRP, 4–6×/day)
   – Supplies platelet-derived growth factors for tissue repair ScienceDirect.

3. Cenegermin (Recombinant Human Nerve Growth Factor, 20 μg/mL, 6×/day)
   – Stimulates nerve regeneration and epithelial restoration in severe defects PMC.

4. Amniotic Membrane Extract Eye Drops (AMEED, dosage per manufacturer)
   – Contains anti-inflammatory cytokines and growth factors to promote healing PubMed.

5. Topical Basic Fibroblast Growth Factor (bFGF)
   – Enhances fibroblast proliferation and stromal repair (experimental) PubMed.

6. Topical Epidermal Growth Factor (EGF)
   – Induces epithelial cell migration and closure in corneal ulcers Nature.

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Surgical Treatments

When medical therapy fails or perforation is imminent:

1. Therapeutic Penetrating Keratoplasty (TPK)
   – Full-thickness corneal graft to remove infected tissue and restore integrity Medscape.

2. Deep Anterior Lamellar Keratoplasty (DALK)
   – Selective stromal removal, preserving endothelium to reduce rejection risk Medscape.

3. Conjunctival Flap (Gundersen Flap)
   – Conjunctival tissue covers the ulcer, delivering blood supply and inflammation control Medscape.

4. Tarsorrhaphy
   – Partial eyelid closure to protect large epithelial defects (see non-pharma) Medscape.

5. Evisceration/Enucleation
   – Last resort removal of eye contents when infection endangers overall health Medscape.

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Prevention Measures

1. Wear protective eyewear in dusty or agricultural settings

2. Practice strict contact-lens hygiene (no water, daily disinfection)

3. Remove lenses at first sign of redness or discomfort

4. Avoid sleeping in lenses

5. Discard old lens cases quarterly

6. Treat corneal abrasions promptly

7. Avoid topical steroids without antifungal cover

8. Keep living areas dry and mold-free

9. Use sunglasses outdoors to prevent microtrauma

10. Follow up early after any eye injury PMC

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When to See a Doctor

Seek urgent care if you experience any of:
• Severe eye pain unrelieved by lubricants
• Worsening redness or discharge
• Rapid vision loss or new floaters
• Sensitivity to light (photophobia)
• Signs of corneal perforation (sudden tearing, pain) AAO

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Dietary Guidance: What to Eat and What to Avoid

Eat:
• Carrots, sweet potatoes (vitamin A)
• Citrus fruits, bell peppers (vitamin C)
• Nuts, seeds (vitamin E, zinc)
• Fatty fish, flaxseed (omega-3)
• Leafy greens, berries (antioxidants)
• Lean protein (wound repair)
• Yogurt, kefir (probiotics)
• Cucumbers, watermelon (hydration)
• Eggs (lysine)
• Whole grains (steady energy)

Avoid:
• Sugary snacks and drinks
• Processed and fried foods
• Excessive caffeine and alcohol
• Dairy if lactose-sensitive
• Spicy foods that may worsen inflammation
• High-salt foods
• Large meals before bedtime
• Artificial trans fats
• Overly acidic foods (e.g., soda)
• Smoking and vaping PMC

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Frequently Asked Questions

1. What causes fungal keratitis?
   Small corneal injuries or contact-lens contamination allow fungi to invade Wikipedia.

2. How is it diagnosed?
   Corneal scraping for microscopy and culture, sometimes supplemented by confocal microscopy Medscape.

3. Is it contagious?
   No, it results from environmental exposure, not person-to-person spread Wikipedia.

4. How long does treatment last?
   Typically 6–12 weeks of intensive drops, often followed by tapering over months Medscape.

5. Can I wear contact lenses again?
   Only after full resolution and clearance on exam—usually months later Medscape.

6. Will I need surgery?
   About 15–30% of cases require keratoplasty if medical therapy fails Medscape.

7. Can it cause blindness?
   Yes, delayed treatment risks scarring and blindness EyeWiki.

8. Are there home remedies?
   Warm compresses and artificial tears help comfort but don’t replace antifungal drugs Medscape.

9. Do steroids help?
   No—steroids worsen fungal growth and are avoided until infection is fully controlled Medscape.

10. What’s the difference from bacterial keratitis?
    Fungal keratitis progresses more slowly, often shows feathery infiltrates, and responds to antifungals rather than antibiotics Wikipedia.

11. Is a patch helpful?
    A protective eye shield (not a full patch) guards the cornea—full patching is usually avoided to prevent anaerobic growth Medscape.

12. Can nutritional supplements prevent it?
    A healthy diet supports immunity but cannot prevent direct fungal invasion PMC.

13. What environment increases risk?
    Warm, humid climates with agricultural work or water exposure raise risk PMC.

14. Are newer therapies available?
    Yes—CXL, PDAT, and growth-factor drops (e.g., cenegermin) are promising adjuncts PMCPMC.

15. How often should I be examined?
    Initially daily, then every few days as healing progresses, per your ophthalmologist’s plan Medscape.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 04, 2025.

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