Candida Keratitis and Clinical Outcomes
Fungal keratitis, or keratomycosis, is a relatively rare but important cause of ocular morbidity. The total incidence of these ocular infections appears to be increasing globally, as the predominance of pathogen shifts and emerging risk factors are identified. Climate is believed to be associated with the patterns of fungal growth.A study was conducted to examine the epidemiological characteristics, trends, risk factors, management strategies, and clinical outcomes of Candida albicans and non-albicans keratitis over a 15-year period.

Twenty-one cases of Candida keratitis were identified (62.5% of total fungal keratitis; 10 C. Albicans and 11 nonalbicans). The most commonly associated risk factors were topical steroid use (16 patients, 76%), ocular surface disease (15 patients, 71%), contact lens use (11 patients, 52%), and previous corneal surgery (8 patients, 38%); all patients had 2 or more combined risk factors. The number of patients with a visual acuity of 20/200 or better remained the same before and after the treatment (5/21, 24%). The mean duration of the antifungal treatment was 126 days. Sixteen patients ultimately required surgical management (76%; 12 therapeutic keratoplasties, 3 enucleation, and 1 optical keratoplasty). When comparing C. albicans with non-albicans keratitis, found no difference in presenting visual acuity, final visual acuity, or requirement for surgical management.

Candida keratitis accounts for the most identified fungal keratitis cases in this temperate climate area. Exposure to multiple risk factors appears necessary. Surgical intervention is required for the resolution of most cases. Different subspecies of Candida ultimately resulted in similar clinical outcomes.