At first it may present like a common eye infection which is red, painful or watery. But when fungi get into the clear front part of the eye we have a more serious issue. This type of fungal eye infection which goes by the name of fungal keratitis affects the cornea and requires prompt medical care.
The eye may become infected after an injury which in turn may be from plant material, soil or dust which gets in to the eye. Also at risk are contact lens wearers and also people with preexisting eye conditions. As the early signs of this infection may present like that of a bacterial or other eye infection it is important to see an eye care professional for diagnosis.
Without proper care the infection may develop into a fungal corneal ulcer, cause corneal scarring and affect vision. Early diagnosis and the right fungal eye infection treatment can significantly influence the outcome.
What Is Fungal Keratitis?
Fungal keratitis which is also referred to as keratomycosis is an infection of the cornea by fungi. The cornea is the clear dome shaped tissue that covers the colored portion of the eye and the pupil. It also plays a key role in the refraction of light and thus in maintaining clear vision. Also in use is the term keratomycosis which refers to the fungal infection of the cornea.
Fungi in general do not get into the intact healthy cornea. An injury which affects the surface of the cornea may give fungi a chance to enter the tissue. Once inside they may begin to multiply and cause inflammation. At times people use terms like fungus in eye or eye fungus which in fact describe different fungal issues which affect the eye. When the cornea itself is infected the term for this is fungal keratitis which is the more accurate diagnosis.
The infection is not generally spread from one person to another.
What Are the Symptoms of a Fungal Eye Infection?
Symptoms may present itself days to weeks post exposure to the fungus. Also they may present in a way that is similar to that of bacterial and viral and other types of keratitis which is a reason that symptoms by itself may not point to the cause.
Common fungal eye infection symptoms are redness, pain or discomfort which increases, excessive tearing, blurred or reduced vision, light sensitivity, eye discharge and the feeling that there is a foreign body in the eye. Also some may see a white or grayish spot on the cornea which may be a corneal infiltrate or ulcer and should be checked right away by an ophthalmologist.
| Symptom | What You May Notice |
| Eye redness | Persistent redness that does not settle |
| Eye pain | Mild discomfort that may gradually become stronger |
| Blurred vision | Difficulty seeing clearly from the affected eye |
| Light sensitivity | Discomfort in sunlight or bright indoor lighting |
| Excessive tearing | Continuous watering from the eye |
| Eye discharge | Unusual discharge around the affected eye |
| Foreign-body sensation | Feeling of grit, dust or something inside the eye |
If you notice any of these symptoms when wearing contacts remove the lenses and go to see an eye care professional rather than putting them back in. Also as per the CDC if you have symptoms that point to keratitis you should see an eye doctor as soon as possible.
What Causes a Fungal Eye Infection?
A fungal eye infection is when disease causing fungi get into at risk eye tissue. We see that different species of fungi are the cause. In that we have filamentous fungi like Fusarium and Aspergillus which are known to cause it, also yeasts like Candida may infect the cornea.
One issue that presents a risk is trauma which results from plant or vegetable material. For instance an eye may be injured by a pine branch, leaf, crop, grass or agricultural product. What happens is that fungi present in the environment get in through the broken corneal surface. Also this infection may present with the use of contact lenses, after previous eye surgery, in association with preexisting ocular surface disease or reduced immunity.
Not every eye injury leads to fungal keratitis. However, redness, pain or blurred vision following an injury involving soil or plant material should never be ignored.
Who Is More Likely to Develop Fungal Keratitis?
People that work outside or which handle plants, crops and soil report to have issues which cause corneal injuries. Thus farmers, gardeners and agricultural workers should put in place measures to prevent eye injuries. Also contact lens users may report to have developed infectious keratitis at large scale when proper lens hygiene is not a practice.
Others include past corneal disease, eye surgery, continuous disruption of the eye surface and certain health conditions or medications that suppress the immune system. The presence of a risk factor does not confirm a fungal eye infection. An ophthalmologist must examine the eye and may perform laboratory testing to determine the responsible organism.
Fungal Corneal Ulcer: Why Is It Serious?
A corneal ulcer is a break in the skin or an area of tissue damage on the cornea. If fungi are the cause of the infection it may be called a fungal corneal ulcer. For good vision the cornea has to be transparent. Severe infections may damage tissue which may leave scar tissue even after the infection has gone. In serious cases infection may go in to the deeper layers of the cornea causing thinning or perforation of the cornea and thus threatening sight.
This is that delay fungal corneal ulcer treatment or use of over the counter medication is not advised. Pain, redness and vision changes that are getting worse require in particular early assessment.
How Is Fungal Keratitis Diagnosed?
An ophthalmologist will first ask about when the symptoms presented and if there was a recent eye injury, contact lens use, eye surgery or exposure to plant matter or soil. The eye is then examined with a slit lamp which allows the ophthalmologist to look at the cornea in great detail.
When keratitis is infected a sample from the affected area of the cornea may be taken. The corneal scraping is looked at under a microscope and also cultured to determine the cause. Corneal scraping for microscopic analysis and culture is a very important tool in the diagnosis of fungal keratitis.
In some cases we may use tools like polymerase chain reaction testing or confocal microscopy to clarify a diagnosis which does not present with definitive results from standard tests. Proper identification is key which in turn determines the appropriate treatment for bacterial, fungal, viral and parasitic corneal infections.
What Is the Treatment for Fungal Eye Infection?
The main approach to fungal eye infection treatment is antifungal medication which is provided by an ophthalmologist. What we do depends on the type and degree of infection, what we think is the cause of the infection and how the cornea reacts.
Natamycin eye drops are the go to therapy for most cases of filamentous fungi. For other infections we may use amphotericin B or voriconazole in certain cases based on the type of organism and what is best for the patient.
| Treatment Approach | When It May Be Considered |
| Antifungal eye drops | Main treatment for many fungal corneal infections |
| Alternative or additional antifungal medicines | When the organism or response requires another approach |
| Oral/systemic antifungal medicines | Selected severe or deeper infections |
| Close follow-up | To monitor whether the ulcer is shrinking and healing |
| Surgical treatment | Severe, progressive or treatment-resistant cases |
Fungal keratitis treatment is a condition which often requires greater patience in treatment as compared to some bacterial infections in that the antifungal agents may be required for a much longer time. The ophthalmologist will determine the frequency of the medication and the point at which it may be safely reduced.
Patients should not stop prescribed medication simply because redness or pain begins to improve.
Can Surgery Be Required for a Fungal Corneal Ulcer?
Many medical approaches will work on these cases when they are identified early enough, but we see that some very serious infections do not fully respond to medical treatment. Should a fungal corneal ulcer progress, cause extensive tissue damage, or put the cornea at risk of perforation we may turn to surgery.
In some more severe cases we see the need for excision of affected tissue and also for transplant of the cornea. The aim of the procedure is to eliminate the infection, preserve eye structure and to save as much vision as we can. What is done is based on the extent, the site and the degree of the infection and how it responds to anti fungal treatment.
What Should You Avoid During Fungal Keratitis Treatment?
Self care can complicate diagnosis and treatment. Do not use up old vials of eye drop from a past eye infection which may present with the same symptoms. With steroids in eye drops in particular do only what the ophthalmologist says to do when you think you have an infection. Some medicines may change the picture of a corneal infection or how it progresses and should not be started out without specialist advice.
Contact lenses should also be out of use during an active infection which is to say that you should not wear them at that time unless an eye specialist gives you the ok to do so. Also do not rub the affected eye. We will get you in for follow up visits as scheduled which is to see how the infection is responding to treatment.
Is Fungal Infection Around the Eyes the Same as Fungal Keratitis?
No. A fungal infection around eyes we see to be that which affects the skin around the eyelids or eye area. On the other hand we have fungal keratitis which affects the cornea. Both may include fungi as a pathogen but in terms of location, what complications may present, and treatment they are different.
If you have redness or irritation of the eyelids along with eye pain, sensitivity to light, discharge or reduced vision, an eye exam can help determine if the infection is of the eye or the skin around it.
Can Fungal Eye Infection Be Prevented?
Not all cases are preventable, but we do what we can to reduce the risk of them which we can. Eye protection is a good idea when you are working with crops, plants, wood, soil or machinery that is going to shoot out particles into the eyes. After an eye injury which may have come from plant material, see a health care professional if you notice redness, pain, watering in the eye or if your vision has become blurred.
Contact lens users should follow recommended hygiene practices, avoid exposing lenses to potentially contaminated water and replace lenses and storage cases according to professional guidance.
Most importantly, avoid treating a painful red eye at home for several days before seeking help.
When Should You See an Eye Doctor?
Present to the ophthalmologist as soon as possible when you have redness which is also with pain, blurred or reduced vision, light sensitivity, discharge or persistent tearing. Also pay extra attention if symptoms present after an eye injury which includes a plant, crop, branch, soil or dust.
A progressive fungal eye infection which may cause scarring of the cornea thus waiting out the symptoms may in fact worsen your prognosis.
Conclusion
A serious issue of fungal eye infection which affects the cornea should not be treated like a routine red eye. Fungal keratitis also known as keratomycosis may present after an eye injury, contact lens wear or any other break in the corneal surface.
Pain, redness, blurred vision, excessive tearing and sensitivity to light are key warning signs. As these symptoms also present with other infections, diagnosis of eye fungus requires an ophthalmic exam as a matter of fact not guesswork.
When a fungal corneal ulcer is identified at an early stage and proper fungal keratitis treatment is given out right away we see better results in terms of controlling the infection and also in reducing the risk of corneal scarring and vision loss.
Frequently Asked Questions About Fungal Keratitis
1. Can fungal keratitis cause permanent vision loss?
Yes. Severe cases of fungal keratitis which may cause scarring of the cornea thus affecting vision. Also we see in advanced cases a report of deeper tissue damage or other complications. Early diagnosis is key as well as appropriate treatment which in turn improves chances of controlling the infection before the cornea is damaged beyond repair.
2. How do I know whether I have fungus in my eye?
You do not do a reliable job at identifying fungus in eye by symptoms alone. Pain, redness, blurred vision, tearing and light sensitivity also present with many eye infections. An ophthalmologist will look at the cornea and do a corneal scrape or send out for lab work to determine the cause.
3. What are the first fungal eye infection symptoms?
Early fungal eye infection symptoms may present as redness, pain or discomfort, watery eyes, blurred vision, sensitivity to light and discharge. Symptoms which may not appear for days to weeks after an episode of eye injury or use of contact lenses should also be brought up at your eye exam.
4. How long does fungal keratitis treatment take?
Fungal keratitis treatment time is variable. It depends on the type of organism, the depth and size of the infection, how soon treatment is started and how the eye responds. Treatment may extend for many weeks which is under the watchful ophthalmologist care.
5. Is eye fungus contagious?
Fungal keratitis is also not a condition which is known to spread from person to person. It usually results from fungi that enter the eye via an injury or a susceptible area of the corneal surface.
6. Can fungal keratitis heal completely?
Yes indeed some infections respond very well to early fungal eye infection treatment. But in the case of more serious infections we see development of corneal scarring which in turn affects vision. What we find is that recovery is a function of the degree of infection, the type of organism present, the time of treatment onset and the patient’s response to the therapy.