Cornea: Fungal Infection

What is a fungal infection of the cornea?

An infection of the cornea (the clear outer layer of the eye) by fungus is called fungal keratitis. It can cause a breakdown of the cornea, which is called a corneal ulcer. The ulcer can cause swelling and cloudiness of the cornea and a decrease in your vision.

What is the cause?

There are several common types of fungi that cause infections:

• Aspergillus
• Fusarium
• Candida (yeast)

These fungi cannot usually infect a healthy cornea. However when there are tiny breaks in the outermost layer of the cornea, these fungi can reach the cornea and cause an infection.

Anything that causes a break or scratch in the cornea can lead to a fungal infection, but you have a greater risk if you get a scratch on your eye from any plant matter. Improper use of contact lenses, such as not cleaning your contacts properly or sleeping in your contacts, can also increase the risk of a fungal infection. Using steroid eyedrops may also increase your risk.

What are the symptoms?

Symptoms of fungal keratitis include:

• gritty feeling
• watery eyes
• decreased or cloudy vision
• light sensitivity (photophobia)
• redness and irritation of the eye

How is it diagnosed?

Your healthcare provider will ask about your symptoms, examine your eyes, and do tests to identify the cause. Tests you may have are:

• an exam using a special microscope (a slit lamp) to look closely at your cornea
• an exam with drops and special lenses to look into the back of your eye (a dilated exam)
• culture and stain of cornea tissue to look for the cause of your infection under a microscope
• an ultrasound test to look at the back of your eye if you have a severe infection

How is it treated?

Fungal keratitis is a very severe condition and can be hard to treat. Your healthcare provider may first prescribe antibiotic drops. This is because it can take several days for tests to show what is causing the infection. When you are diagnosed with fungal keratitis, your provider will prescribe eye drops to treat fungal infections. You may need to use these eye drops every couple of hours, even during the night. You may also be given antifungal pills to take by mouth.

How long will the effects last?

If not treated right away, fungal keratitis can cause blindness. You need to see your eye care provider often to make sure that the infection is getting better.

Fungal keratitis can lead to a permanent scar even after successful treatment. If this scar limits your vision, your provider may treat it with a contact lens, laser treatment, or surgery.

How can I take care of myself?

If you have any of the symptoms of a fungal infection after getting something in your eye, or if you wear contact lenses, contact your healthcare provider right away. If you are given drops to use, be sure to follow your healthcare provider's instructions carefully and keep all of your follow-up appointments.

How can I help prevent fungal keratitis?

• If you wear contact lenses, wash your hands before handling them, clean your contacts as instructed. Do not wear contact lenses while sleeping or swimming.
• If you work in a place where things may get into your eye, wear goggles at all times.