Fungus infection of the cornea: a review of 43 cases

ABSTRACT

Forty-three proven cases of fungus infection of the cornea have been studied in the Philippine Eye Research Institute since 1968. Clinical features that suggested the nature of the infection included the (a) history of previous ocular trauma due to some vegetable matter, (b) severity of the pain on the affected eye, (c) non-response to prolonged anti-bacterial therapy, (d) preponderance of hard ulcers indicating minimal tissue necrosis, and the (e) hypopyon, when present, tended to be stringy and well-adherent to the back surface of the corneaEtiologic diagnosis requires demonstration of the organism in smears, cultures or preferably in the biopsy specimens. For this purpose, it is advised that the specimens should include portions of the advancing borders of the lesionsFusarium and Aspergillus which are plant pathogens were the most common fungi isolated from the cases. Others included Mycelia sterila, Hormodendrum, Curvularia, Phialophora verrucosa, Cephalosporium, Paecilomyces and Candida kruseiMedical therapy of the infection was not very encouraging. Part of the reason is that while the antifungal drugs are effective in-vitro against a wide variety of fungal cultures, they poorly penetrate the cornea. Surgical excision of the lesion removed a bulk of the infecting organisms and when used in conjunction with the antimycotic drugs, the procedure helped control the infection. (Summary)