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What’s Fungal Keratitis?

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Fungal keratitis is a condition where the cornea becomes inflamed and swollen due to a fungal infection. Symptoms include red or sore eyelids, burning eyes, and reduced vision. Direct contact with plant matter or contaminated contact lenses can cause the condition. Treatment involves antifungal eye drops and hand washing to prevent the infection from spreading. Successful treatment can be a long process.

With keratitis, the cornea becomes irritated and swollen. This can happen due to a number of causes. One potential cause is infection through a fungus (yeast or mold). If a fungal infection causes keratitis, this condition is called fungal keratitis. The condition requires treatment so that the inflammation of the cornea is under control.
A person may not know whether they have fungal keratitis or keratitis caused by bacteria. Indeed, it is not easy to diagnose, even when examined by an ophthalmologist. Signs of fungal keratitis usually start with red or sore eyelids and then progress to more symptoms. These can include burning eyes or repeated itching.

Some people notice excessive watering or tearing of a single eye, which is also bloodshot. It may be possible to see a white dot on the cornea (although not always). Tolerating light becomes more difficult and many have photosensitivity. In general, people may notice a reduction in their ability to see things. Another feature of fungal keratitis is eye pain, which can be significant.

There are a few ways fungal keratitis is likely to occur. Direct contact with plant matter to the eye, such as being hit by a branch, could transfer some forms of fungus to the eye, which then begins to grow. In the mid-2000s, there was a sharp increase in fungal keratitis cases due to people using contaminated contact lenses. When the problem was discovered, the lenses were removed from the market. Contact lens wearers generally seem to be more at risk of getting this condition, but the ability of fungi to build up in the eye may also be more likely in people who have suppressed immune systems. However, sometimes the condition occurs in people who are in very good health.

It is extremely important for people with keratitis to see an ophthalmologist for diagnosis. If the condition is fungal or bacterial keratitis, it needs to be treated to protect the cornea. Doctors may take a small swab in the eye to confirm the presence of bacteria or fungi. Those these conditions are related, they cannot be treated the same. Adding antibacterial eye drops to a fungus-infected eye is likely to make the problem worse. So essentially, doctors will want to confirm the agent that creates the keratitis before offering treatment.

Treatment is often in the form of antifungal eye drops. For very severe cases, oral antifungal drugs might be considered, although they are not thought to be effective. As treatment progresses, people are usually warned not to touch their eyes more than is necessary to prevent the fungal keratitis from spreading. Hand washing after each hand-to-hand contact is strongly recommended. Contact lens wearers may need to give up wearing their lenses while treatment is ongoing and may need to replace their current lenses so the infection doesn’t come back after it’s been treated.

Successfully treating fungal keratitis can be a long and difficult process. In addition to your daily eye drops, you may need a variety of medications to get your infection under control.

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