DR. KANIKA BHARDWAJ

Dr.Jyoti Batra

Abstract

CASE REPORT: 56-year-old female agriculture worker presented with intense ocular pain, redness, foreign body sensation, decreased vision in the right eye from past one month. Presenting VA in RE was FC@5mtr and LE was 20/40. She was on multiple eye drops. SLE of Right eye showed conjunctival congestion, paracentral epithelial defect 7mmx7mm, with corneal infiltrate involving mid stroma, quiet anterior chamber and cataractous lens. KOH showed fungal hyphae. Patient was put on eyedrops-Natamet half hourly, Vigamox one hourly, Mydryn thrice a day for a week but ulcer showed no signs of improvement. Laboratory culture confirmed Cladosporium species. Treatment was switched to topical(1mg/ml) and oral voriconazole(200mg). After 2 weeks, infiltrate started resolving and residual 1 mmx1mm ulcer remained. After 1 month of treatment, the keratitis healed completely and the BCVA in RE was 20/40with +0.25 D Sph.

CONCLUSION: Voriconazole could be a good choice for refractory fungal keratitis.