Fungal keratitis: Emerging trends and treatment outcomes

Sandhya A. Iyer, Sonal S. Tuli, Ryan C. Wagoner

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


PURPOSE. To review the trends, risk factors, causative organisms, treatment, and outcomes of fungal keratitis at the authors' institution. METHODS. A retrospective review of the records of consecutive patients diagnosed with fungal keratitis at the authors' institution from January 1999 to June 2006. RESULTS. Eighty-four patients were diagnosed with fungal keratitis during this period. The average age of the patients was 48 years, and 64% were male. Until 2004, trauma (51%) and contact lens use (40%) were the major risk factors. After 2005, contact lens use (52%) surpassed trauma as the most common risk factor (29%). The percentage of fungal ulcers caused by nontherapeutic contact lenses increased from 21% between 1999 and 2001 to 32% between 2002 and 2004 and to 45% in 2005 and 2006. Eighty-six percent of cultured organisms were filamentous. Fusarium (41%) was the most commonly isolated genus, followed by Candida (14%), Curvularia (12%), and Aspergillus (12%). Visual acuity was worse than 20/200 in 56% of patients at presentation. Final visual acuity was 20/40 or better in 70% of patients treated with medication alone and 16% of patients requiring therapeutic keratoplasty. Surgical intervention in the acute phase was necessary in 23% of patients. Seventy-four percent of medically treated patients had dual topical antifungal therapy. Natamycin 5% and amphotericin B 0.15% were the most commonly used drugs. CONCLUSIONS. Contact lenses are a major risk factor for fungal keratitis. The incidence of contact lens-related fungal keratitis was increasing even before the Fusarium outbreak in 2005 and 2006. Good visual outcomes can be achieved by aggressive dual topical antifungal therapy.

Original languageEnglish (US)
Pages (from-to)267-271
Number of pages5
JournalEye and Contact Lens
Issue number6
StatePublished - Dec 2006


  • Contact lens
  • Fungal keratitis
  • Fusarium
  • Ulcers

ASJC Scopus subject areas

  • Ophthalmology


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