Diagnosis and treatment of keratomycosis and fungal endophthalmitis

Keratomycosis and fungal endophthalmitis are difficult to treat and prognosis is usually severe and depends on early diagnosis and treatment. Keratomycosis requires topical treatment with broad-spectrum antimycotics such as amphotericin B, natamycin or more specifics eyedrops for yeasts as fluconazole, 5-flucytosine. In severe infections voriconazole or caspofungin eyedrops have been used on compassionate use basis with careful monitoring of patients because little is known about their possible side effects on the cornea. Deep infections in the stroma and endophthalmitis require a local and systemic treatment. In recent years, voriconazole and caspofungin have improved treatment considerably and allow a better prognosis for these infectious diseases.