Fungal infections of the eye

Abstract

Fungi are living organisms that are useful in the nature for cellulose degradation and decay of organic matter. They are useful for antibiotic synthesis and food maturation. At the same time there are several species that are pathogenic to man, animals and plants. They can cause infections in ocular tissues such as cornea, sclera, choroides, retina and vitreous. Fortunately, fungal infections are not frequent and are basically opportunistic infections. The exogenous infection is more common in tropical and subtropical parts of the world owing to their abundance in the environment as saprophytes. Prolonged treatment with corticosteroids or broad spectrum antibiotics, diabetes, acquired immunodeficiency syndrome, organ transplantation, malignancy and immunodeficiency conditions are some of the risk factors that may contribute to fungal infections. This review article is confined to ocular fungal infections, their pathogenesis, epidemiology, clinical features and laboratory diagnosis in brief. By far, fungal infections are easier to diagnose than treat. Availability of antifungal drugs is limited and a majority of them have serious side effects. Antifungal susceptibility testing is not common and data related to the development of resistance are meagre. Ophthalmic preparations for the treatment of fungal infections of the eye are very few and off label use of systemic antifungals as topical drugs is common. The science of fungal ocular infections is still evolving, with increasing data coming from just a few countries.