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Invited Commentary
June 2017

Challenges in the Management of Fungal Keratitis

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore
JAMA Ophthalmol. 2017;135(6):525-526. doi:10.1001/jamaophthalmol.2017.0722

Fungal keratitis is a challenging ophthalmologic condition that requires a high level of suspicion and aggressive treatment to prevent untoward outcomes. Identifying this condition, in turn, necessitates an understanding of the regional demographic features of infectious keratitis. Fungal keratitis is more commonly encountered in the tropical and subtropical parts of the world, such as in south India, where fungi cause up to 47% of keratitis cases1 and where filamentous fungi, such as Fusarium and Aspergillus, predominate. However, fungal keratitis also occurs in the more temperate areas of the world but more often caused by yeasts, such as Candida. However, exceptions occur, such as with the Fusarium outbreak that was associated with contact lens wear.2 Although there continues to be controversy with regard to the best antifungal treatment for various types of fungal keratitis, an understanding of the suspected causative organism when initiating treatment is still essential.

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