A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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Fungal keratitis

Fungal Keratitis

Fusarium keratitis, Aspergillus keratitis , Candida keratitis

Symptoms

  • Acute severe pain
  • Extreme redness
  • Epiphora and photophobia
  • No improvement with lens removal

Signs

  • Typically unilateral
  • Localized corneal infiltration, often with feathery margins and elevated edges. Satellite lesions may also be present
  • Penetration of infiltrate into the stroma with surrounding edema.
  • Hypopyon
  • Anterior chamber reaction
  • Severe hyperemia and possibly lid edema

Etiology

  • May follow trauma (generally with plant material) to the cornea
  • Inappropriate use of care systems (e.g. topping off, poor case hygiene) may result in product contamination by Fusarium spp.

Prevalence

  • Very rare

Differential Diagnosis

Management

  • Cease lens wear immediately
  • Consider culturing before initiating antimicrobial therapy, particularly for large central ulcers
  • Instigate topical antifungal treatment
  • Deeper infections may require systemic antifungal medication
  • Treatment may be required for several months
  • Replace all lenses and lens care products including lens case before recommencing lens wear
  • Further lens wear should be restricted and be undertaken cautiously

Alcon Vision Care is uniquely poised to serve every contact lens wearer by addressing the full life cycle of their needs.