Candida is the most common isolate of keratitis

In a review of culture-positive fungal keratitis seen at Moorfields Eye Hospital, London, UK, over a 13-year period, Candida has been identified as the principal isolate, according to the results of a study published in the October issue of Cornea.

Stephen Tuft and colleagues retrospectively identified isolates from laboratory reports and reviewed the clinical records. The fungal type, risk factors for infection, in vitro sensitivity and clinical outcome were recorded.

The researchers found 66 isolates from 65 patients, 40 of which were subspecies of Candida. The average interval from the onset of keratitis to confirmation of fungal infection was 3.4 weeks. Prior ocular surface disease or a penetrating keratoplasty (PK) was present in 97.4% of patients with Candida infection and 74.4% of patients with Candida infection were using topical steroids at the time of diagnosis.

The principal risk factors for filamentary fungal infection were trauma (30.8%) or cosmetic contact lens wear (30.8%), with ocular surface disease or a prior PK present in five (19.2%) cases.

The results of this review suggest that Candida is the principal isolate and is usually found in eyes with ocular surface disease or a prior PK treated with topical steroids.