Keratomycosis after incidental spillage of vegetative material into the eye: Report of two cases
A 48-year-old female patient presented with redness and pain in the right eye. She had a history of incidental spillage of nut water into her right eye while eating nuts 11 days ago. She was also on medication as a diabetic case from several years ago. Over the last 11 days, she had been treated in another center with homatropin, NaCl, gentamycin eye drops, and ketoconazole (oral). Examination revealed decreased VA to be as equal as hand motion in the right and 6/10 in her left eye. A 4 + injection was noted within conjunctiva. A 4 × 5 mm central corneal ulcer with feathery margin and dry appearance was noted. Associated hypopyon was less than 0.5 mm [].\nDirect smear and culture from the ulcer was positive for mycelia and Aspergillus species, respectively.\nThe patient was treated with ketoconazole (200 mg/day, oral), doxycyclin (100 mg/12 h, oral), amphotricin, homatropin, and vitamin C eye drops. Follow-up session at one month showed resolved fungal keratitis and partial improvement in right VA (1/10). Due to the development of neurotrophic ulcer and persistent epithelial defect (PED) in the cornea, the patient underwent amniotic membrane transplantation (AMT) and was discharged. Follow-up at 1 year revealed no further improvement in VA.