The medical professional must first confirm that the cause of the keratitis is fungal, rather than viral, bacterial, or otherwise. That identification is made by taking a tiny sample of tissue from the eye, and examining the sample carefully. Once confirmed, the doctor may begin treatment.
Treatment of fungal keratitis is time-consuming. The treatment for fungal keratitis often must take four weeks or more. The treatment often requires application of drugs but also surgical procedures to remove dead tissue, and the treatment can be complicated if the physician does not know the proper cause of the disease.
The cause of the disease is a fungus, and the disease is best treated with an anti-fungal medicine. Natamycin is commonly used to treat fungal keratitis. Natamycin is a naturally-occurring agent that is used as a food preservative due to its ability to prevent the growth of molds. Voriconazole is another drug that is gaining favor. Voriconazole slows the growth of fungi. Other anti-fungal drugs include amphotericin (a very strong anti-fungal agent, with strong warnings about side effects) and flucytosine.
Antibiotics are also used in the treatment of fungal keratitis in order to kill bacteria, if necessary. Steroids are strongly discouraged. They will assist the growth of the fungus and make the disease worse.
If the disease has progressed to the back of the eye (the aqueous), it may be difficult for the anti-fungal drugs to penetrate that deeply into the eye. The recommended method of making sure the drugs reach that part of the eye is to debride the cornea. Debridement is the removal of dead or damaged tissue, in this case the removal of fungal-contaminated tissue from the affected eye.
If the cornea has been damaged, a physician may recommend corneal transplant.
This is a procedure that replaces damaged corneal tissue with healthy corneal
tissue from an organ bank.
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