Fungal Keratitis: Risks and Treatment After Eye Injury

Q: Fungal Keratitis: Risks and Treatment After Eye Injury

Hello： If the cornea is not scratched, it is unlikely to be infected by fungi. <br>If it is scratched, the eye will be very painful and may not open, with excessive tearing. <br>Since there is currently no discomfort in the eye, the chance of infection is very low! Gentamicin is

Fungal keratitis

I was walking in an alley and had to dodge the hot air from an outdoor unit for a short distance.
I confirmed that there were no cars around, so I intentionally closed my eyes for 10 seconds.
However, due to the dim lighting, I didn't notice and bumped into a potted plant on the side of the road.
At that moment, I was wearing safety goggles, but they got knocked off my face.
I wasn't sure if any leaves directly hit my eyes, but I am certain that some leaves brushed against my tongue.

I would like to ask the doctor if hitting the eyes could lead to fungal keratitis, as there are no clinics open tomorrow, and I plan to get checked the day after.
Can an examination reveal any infections? Additionally, I found some information stating that antibiotics can worsen this type of keratitis infection.
I have a medication called Stop Pus (sulfonamide antibiotic from Hsin Kuei).
Is it suitable for treating this type of condition, or should I avoid using it? Thank you.

Niming, 30~39 year old female. Ask Date: 2019/06/01

Dr. Gao Pilin reply Ophthalmology

Hello: If the cornea is not scratched, it is unlikely to be infected by fungi.
If it is scratched, the eye will be very painful and may not open, with excessive tearing.
Since there is currently no discomfort in the eye, the chance of infection is very low! Gentamicin is ineffective against fungal infections, but it can be used to rinse the eye and wash out some debris.
When there is an opportunity for a consultation, it is still advisable to have a doctor examine it for peace of mind.
The ophthalmology department at Puzi Hospital in Taiwan is open: Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM, and Wednesday from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; if necessary, it is important to seek medical care at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2019/06/01

More Info

Fungal keratitis is a serious eye infection that can occur after an eye injury, particularly if the injury involves exposure to organic materials, such as plant matter. In your case, while you were wearing protective goggles, the fact that the goggles were dislodged and you may have had contact with a plant leaf raises some concerns about potential exposure to pathogens, including fungi.

Risks of Fungal Keratitis After Eye Injury
1. Injury Type: Fungal keratitis is more likely to occur if the eye is injured by organic materials, such as leaves or soil, which can introduce fungal spores into the eye. Even if you were wearing goggles, if they were knocked off and the eye was exposed, there is a risk.

2. Symptoms to Watch For: After an injury, it’s crucial to monitor for symptoms of infection. These may include:
- Redness of the eye
- Increased pain or discomfort
- Blurred or decreased vision
- Sensitivity to light (photophobia)
- Discharge from the eye
- A feeling of something in the eye (foreign body sensation)
3. Timing of Symptoms: Symptoms of fungal keratitis can develop over several days after the initial injury. If you notice any of the above symptoms, it is essential to seek medical attention as soon as possible.

Treatment Considerations
1. Antibiotics and Fungal Infections: You mentioned having Sulfamethoxazole (止濃敏), which is a sulfonamide antibiotic. While antibiotics are effective against bacterial infections, they do not treat fungal infections. In fact, inappropriate use of antibiotics can sometimes worsen a fungal infection by disrupting the normal flora of the eye and allowing fungi to proliferate. Therefore, it is not advisable to use this medication for suspected fungal keratitis.

2. Proper Treatment: If fungal keratitis is suspected, antifungal medications are required. These may include topical antifungal drops, such as natamycin or voriconazole, depending on the severity and type of fungal infection. A healthcare professional will determine the appropriate treatment based on a thorough examination.

3. Follow-Up Care: Since you plan to visit a clinic the day after the incident, it’s important to communicate all details of the injury to your healthcare provider. They may perform a slit-lamp examination to assess the cornea and check for any signs of infection or damage.

Preventive Measures
- Avoid Rubbing the Eyes: After an injury, it’s crucial to avoid touching or rubbing the eyes, as this can introduce more pathogens.

- Maintain Hygiene: Wash your hands frequently and avoid touching your face, especially the eyes, to minimize the risk of infection.

- Protective Eyewear: In the future, ensure that protective eyewear fits securely and is appropriate for the activity to prevent injuries.

Conclusion
In summary, while the risk of fungal keratitis exists after an eye injury involving organic material, early detection and treatment are key to preventing serious complications, including vision loss. If you experience any concerning symptoms, do not hesitate to seek immediate medical attention. Your eye health is paramount, and timely intervention can make a significant difference in outcomes.

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