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June 2011

Natamycin and Voriconazole in Fungal Keratitis

Author Affiliations

Author Affiliations: Kallam Anji Reddy Campus, Prasad Eye Institute, Hyderabad, India.

Arch Ophthalmol. 2011;129(6):805-820. doi:10.1001/archophthalmol.2011.97

The article titled “Comparison of Natamycin and Voriconazole for the treatment of fungal keratitis” by Prajna et al was read with interest.1 We offer a few comments and questions.

First, the authors have mentioned that, for the purpose of masking, the residue of Natamycin eye drops was wiped clean by the ward nurses in an attempt to prevent the examiner from guessing which eye drops have been instilled. It is our observation that the white residue actually adheres to the epithelial defect of the ulcer; this can only be removed by using a sterile, cotton-tipped applicator or a No. 15 blade after topical anesthetic application. Thus, complete masking in all cases would be difficult to achieve.