DR. RAJ SHEKHAR PAUL

DR. ADITI JOHRI

Abstract

Darkly pigmented dematiaceous fungus are a common cause of keratomycosis in India .A 40 years old farmer presented to ER with redness ,watering , diminution of vision in right eye since past 3 weeks.He was diagnosed elsewhere as perforated corneal ulcer with iris tissue prolapse .On examination, hyperpigmented corneal plaque with surrounding stromal infiltrate and hypopyon was noted.On microbiological analysis , septate fungal filaments were seen. He was started on topical and oral anti fungal mediactions, with regular debridements in subsequent visits.In view of inadequate remission he underwent superficial keratectomy and multilayered amniotic membrane transplantation with intrastromal and intracameral amphotericin B injection.After 1 month ,complete corneal scarring was noted with improvement in BCVA from HMCF to 20/60.In such recalcitrant plaques, superficial keratectomy can aid in early remission bypassing the need of therapeutic corneal transplantation.