Diagnosis and medical treatment of fungal keratitis

A significant trend is a move away from yeast infections and toward filamentous fungal keratitis over the past decade

Diagnosis and medical treatment of fungal keratitis
Leigh Spielberg
Leigh Spielberg
Published: Thursday, February 16, 2017
[caption id="attachment_7579" align="alignnone" width="750"]Matthew Burton Matthew Burton[/caption] Matthew Burton PhD, London, UK, gave the keynote speech on infectious keratitis at the annual Cornea Day, during the 21st ESCRS Winter Meeting in Maastricht, The Netherlands. “A significant trend is a move away from yeast infections and toward filamentous fungal keratitis over the past decade, which currently cause 70% of fungal infections in our hospital,” said Dr Burton. A reverse trend has been noted in candida infections. Regarding the diagnostic approach, Dr Burton advised delegates to focus on potential risk factors, including contact lens use, ocular surface disease, trauma, surgery and especially tropical travel. “Travel history is often overlooked, despite it’s great importance,” said Dr Burton. The closer the patient has travelled to the equator, the higher the proportion of fungal keratitis. Diagnostics should include in vivo confocal microscopy (IVCM), scrape for microbiology, PCR and biopsy. "IVCM can be a very valuable modality, particularly for deeper infections not amenable to the other diagnostic approaches," he said.
IVCM can be a very valuable modality, particularly for deeper infections not amenable to the other diagnostic approaches
Dr Burton also reviewed the evidence that guided his approach to treatment. The most valuable studies compared topical treatments such as natamycin, voriconazole and chlorhexidine, as well as oral and intrastromal voriconazole. Dr Burton reminded delegates to be particularly careful with oral voriconazole, which can lead to fatal hepatotoxicity. “Despite the potential for success of medical treatments, don’t be afraid to consider surgery with there’s no treatment response or when the limbus becomes involved,” he concluded.
Latest Articles
Nutrition and the Eye: A Recipe for Success

A look at the evidence for tasty ways of lowering risks and improving ocular health.

Read more...

New Award to Encourage Research into Sustainable Practices

Read more...

Sharing a Vision for the Future

ESCRS leaders update Trieste conference on ESCRS initiatives.

Read more...

Extending Depth of Satisfaction

The ESCRS Eye Journal Club discuss a new study reviewing the causes and management of dissatisfaction after implantation of an EDOF IOL.

Read more...

Conventional Versus Laser-Assisted Cataract Surgery

Evidence favours conventional technique in most cases.

Read more...

AI Scribing and Telephone Management

Automating note-taking and call centres could boost practice efficiency.

Read more...

AI Analysis and the Cornea

A combination of better imaging and AI deep learning could significantly improve corneal imaging and diagnosis.

Read more...

Cooking a Feast for the Eyes

A cookbook to promote ocular health through thoughtful and traditional cuisine.

Read more...

Need to Know: Spherical Aberration

Part three of this series examines spherical aberration and its influence on higher-order aberrations.

Read more...

Generating AI’s Potential

How generative AI impacts medicine, society, and the environment.

Read more...