Fusarium Keratitis: General Information And Awareness

What is Fusarium Keratitis?

Fusarium Keratitis is an inflammation of the cornea, the clear membrane that covers the colored part of the eye (iris) and pupil of the eye. It is caused by Fusarium which is a large genus of filamentous fungi widely distributed in soil and in association with plants. The higher incidence of fusarium keratitis among normal contact lens wearers is a new finding.

General Symptoms:

Symptoms of Fusarium keratitis include eye pain, foreign body sensation, redness, tearing, discharge, or light sensitivity. If you experience any of these symptoms, you should return to your optometrist immediately.

Prevention:

Adults and children who wear contact lenses should on a regular basis use sterile lens-cleaning and disinfecting solutions. Tap water is not sterile and should not be used to clean contact lenses. It is important to go for follow-up checkups because small defects in the cornea can occur without the patient being aware of it. Do not overwear contact lenses. Remove them if the eyes become red or irritated. Replace contact lenses when scheduled to do so. Proteins and other things can deposit on the contacts, leading to an increased risk of infection. Rinse contact lens cases in hot water every night, if possible, and let them air dry. Replace contact lens cases every three months. Organisms have been cultured from contact lens cases.

How to treat Fusarium Keratitis

Clinically, it is often difficult to differentiate between fungal and bacterial infections. Confirmation may be obtained by your doctor through corneal culture, corneal tissue biopsy or confocal microscopy. Laboratory results take time to get back, so your doctor may place you on antibiotics pending results. Should fungal treatment be warranted, topical or oral anti-fungal agents may be used. In some cases, surgical intervention is necessary.

However the standard treatment of Fusarium fungal keratitis is frequent use of Natamycin 5% drops, often used every hour around the clock initially. A cycloplegic drop, e.g., scopolamine 0.25%, is also usually used to decrease the inflammation inside the eye. Occasionally, oral antifungal medications, e.g., itraconazole, fluconazole or voriconazole are also used. An urgent corneal transplant may be required in deep infections with impending or frank perforations.

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