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Isolation of common fungi and treatment of mycotic keratitis

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Original Article

Author Details : Jayashree S Shah, Satya Swapnika Y, MS Padma Jothi

Volume : 3, Issue : 1, Year : 2017

Article Page : 69-73

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Abstract

Background: This study was conducted to isolate the common fungi from the corneal ulcer of the patients and to treat fungal keratitis with appropriate antifungal drugs.
Methods: All the patients with corneal ulcer who visited the Ophthalmology OPD at SSMCH, Tumkur were evaluated. Further, all the cases of corneal ulcer were examined with slit lamp biomicroscopy and corneal scrapings taken are subjected to KOH preparation and those with fungal etiology were identified and taken up for the study. The patients were taken into the study irrespective of the previous disease and previous medication.
Results: Out of 20 patients recognised as fungal corneal ulcer, most of the patients belong to the age of 11 to 50 years as they are the working population. The patients with fungal corneal ulcer showed minimal symptoms than signs we lead to delayed avail to treatment. The earliest time the patient visited the hospital after the onset of the disease, was 2 days and the longest duration was 2 months. Those patients with a history of agricultural trauma had either remained negligent in early stage or tried all possible remedies within their easy reach in their initial conditions and come only when the pain became intractable with loss of vision.
Conclusion: A high index of suspicion should be raised in cases with history of trauma and clinical features highly suggestive of fungal corneal ulcer (dry elevated surface, stromal infiltration with hyphate margins). 10% KOH smear is a rapid and sensitive method of diagnosis which is confirmed by SDA cultures that is the most sensitive and specific test available. Aspergillus and Fusarium are the most common isolates. Fluconazole and Natamycin are the drugs of choice in most filamentous keratitis. Most of the cases heal with some grade of opacity, ultimately requiring a therapeutic Penetrating Keratoplasty to regain useful vision.

Keywords: Aspergillus, Corneal ulcer, Corneal opacity, Fungal Keratitis, Fusarium, Penetrating keratoplasty

How to cite : Shah J S, Satya Swapnika Y, Jothi M P, Isolation of common fungi and treatment of mycotic keratitis. Indian J Clin Exp Ophthalmol 2017;3(1):69-73

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