Keratitis is the inflammation of the cornea. Fungi are the most common etiological agents which account for 30–40% of the cases whereas bacteria account for 13–48% of all cases of suppurative keratitis; this varies by geographical area1. Fungal keratitis is an inflammation of the cornea caused by fungi. It is worldwide in distribution, but is more common in the tropics and subtropical regions. Fungal keratitis is an important cause of ocular morbidity and blindness worldwide and is a growing threat that has substantial morbidity and cost. In view of the rise in cases of fungal keratitis in recent years, this study has been undertaken to better understand the epidemiological pattern, microbiological profile, risk factors of fungal keratitis at a Tertiary Eye Care Referral Center - Sarojini Devi Eye Hospital - Hyderabad Telangana. This is a Retrospective study done, at Sarojini Devi Eye Hospital Hyderabad - a tertiary eye care teaching hospital from May 2017 to April 2018 (1 year) and included cases of fungal Keratitis (both OP and IP CASES). All patients with suspected fungal keratitis presenting to the OPD and IPD, at SD Eye hospital Hyderabad were evaluated. Socio-demographic data and information pertaining to the risk factors, clinical presentation was recorded. After provisionally diagnosing Keratitis clinically by the ophthalmologist, corneal scraping and cultures were taken. A presumptive diagnosis was based on clinical features and history, diagnosis was confirmed by KOH preparation and culture. During the study period, 173 patients with suspected fungal keratitis were evaluated. Cultures were positive in 147 cases, though while in 14 cases KOH was positive and culture was negative, they were also included in study. Thus the total cases that were studied were 161. Among these culture positive cases, 11 (6.83%) had mixed fungal and bacterial infections. The most common risk factor was ocular trauma as seen in in 142 cases (82.08%), followed by co-existing ocular disorder in 12 cases (6.94%). The fungal pathogen that was most commonly isolated was Aspergillus spp with 83 (51.56%), followed by Fusarium spp in 56 (34.79%), Curvularia spp 12 (07.45), Penicillium spp. 06 (03.73%), and Candida albicans 04 (02.47%). The maximum incidence was seen in the age group of 41-60 years, and a majority of them were males. The typical clinical features at presentation in this culture-positive fungal keratitis were as follows: dry, thick and raised corneal surface, stromal infiltrates with feathery margins, typical satellite lesions, Hypopyon and corneal abscess. The prompt diagnosis of mycoses requires a high index of suspicion and an appreciation of specific risk factors that may predispose a patient to ocular fungal infections. Determination of the identity of the specific etiological agent of mycotic disease is very important for the therapeutic considerations. The clinical suspicion by an ophthalmologist is the most important factor in making a diagnosis of fungal infection of cornea. Fungal Keratitis most often occurs after a superficial trauma with vegetative or organic materials. Aspergillus spp and Fusarium spp were the most common fungi. These findings have important public health implications for the treatment and prevention of suppurative corneal ulceration. The overall knowledge of fungal keratitis with its clinical determinants and risk factors would aid in general awareness and prevention of complications associated with it.

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