Cornea: Fungal Infection

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KEY POINTS

• Fungal keratitis is an infection of the cornea, which is the clear outer layer of the eye. If not treated right away, fungal keratitis can cause blindness.
• Your child’s healthcare provider will prescribe eye drops to treat the infection. If the infection scars your child’s cornea and limits his vision, your child’s provider may treat it with a contact lens, laser treatment, or surgery.

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What is a fungal infection of the cornea?

Fungal keratitis is an infection of the cornea, which is the clear outer layer of the eye. The infection is caused by fungus. It can cause a sore called a corneal ulcer. The ulcer can cause swelling and cloudiness of the cornea and a decrease in your child’s vision. If not treated right away, fungal keratitis can cause blindness.

What is the cause?

Fungus includes things like yeast, mold, and mildew. A fungus can live in air, in soil, on plants, and in water. Some live on or in the human body. Fungus cannot usually infect a healthy cornea. However, anything that causes a break or scratch in the cornea can lead to a fungal infection, such as:

• Getting scratched in the eye with a fingernail, comb, or twig
• Getting splinters or dirt in the eye
• Not cleaning contact lenses properly or sleeping in your child’s contacts

A fungal infection of the cornea is more likely if your child has conditions that can weaken the cornea or weaken his ability to fight off infection, such as:

• Using steroid eye drops
• Eye surgery
• Rheumatoid arthritis or other problems with the immune system

What are the symptoms?

Symptoms may include:

• Redness in the eye
• Pain, a scratchy feeling, or feeling like there is something in the eye
• Painful sensitivity to light
• Blurry vision
• A white, gray, or cloudy area on your child’s eye

How is it diagnosed?

Your eye care provider will ask about your child’s symptoms and medical history and do exams and tests such as:

• An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your child’s eye
• An exam using drops to enlarge, or dilate, your child’s pupils and a light to look into the back of your child’s eye
• Biopsy, which is the removal of a tiny sample of tissue for testing to find the cause of the infection
• An ultrasound, which uses sound waves to show pictures of the back of your child’s eye

How is it treated?

Your child’s healthcare provider will prescribe eye drops to treat a fungal infection. At first, your child may need to use these eye drops every hour, even during the night. Your child may also need to take antifungal pills by mouth. Your child needs frequent or daily eye exams to make sure the infection is not getting worse.

Fungal keratitis can lead to a permanent scar on the cornea. If this scar limits your child’s vision, your provider may treat it with an eye patch, contact lens, laser treatment, or surgery.

How can I take care of my child?

Follow the full course of treatment your healthcare provider prescribes. Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when he can return to his normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent fungal keratitis?

• Make sure that your child has regular eye exams.
• To help prevent severe eye injuries, make sure that your child wears safety eyewear when he:
  • Is around power tools, chemicals, or splatter of any kind
  • Helps with yard work
• If your child wears contact lenses, make sure that he follows instructions for wearing and caring for them. He should not wear them longer than recommended.