Predicting and Improving Outcomes in Bacterial and Fungal Keratitis
Fungal keratitis is a major cause of visual loss worldwide, especially in tropical climates, where as many as half of all corneal ulcers are reported to be fungal in aetiology. Fungal corneal ulcers tend to have worse outcomes than bacterial ulcers; fungal ulcers tend to be more likely to perforate and to require penetrating keratoplasty. Fungal infections of the cornea are difficult to treat, and available treatment options are limited. The precipitating event for fungal keratitis is trauma with a vegetable / organic matter. A thorn injury, or in agriculture workers, trauma with a plant while cutting the harvest is typical. Bacterial Keratis is most often associated with trauma involving contact lenses.
Better understanding of predictive and prognostic factors in fungal keratitis may improve care. The relationship between potential prognostic factors measurable at the time of diagnosis and important clinical outcomes, such as visual acuity, infiltrate/scar size, time to re-epithelialization of the corneal epithelium, and likelihood of perforation, has not been well characterized. Predictors of clinical outcomes may help guide treatment and management decisions for fungal corneal ulcers.