Dr.Sowmya Peri

Dr. Mounika Gadikota, Dr.Nasrin

Abstract

72 year old male patient presented with complaints of redness and defective vision in the left eye since 1 month. Patient showed stromal haze along with decreased corneal sensations. The patient was diagnosed with stromal keratitis. He was started on topical steroids in tapering doses , cycloplegics , oral acyclovir and showed improvement . Later he presented with 4mm central epithelial defect, overlying 4mm pigmented dry looking infiltrate, 3mm hypopyon. Culture sensitivity was positive for dematiaceous fungi. Topical natamycin eyedrops, oral ketoconazole were started with oral acyclovir. B scan showed moderate vitreous echoes in anterior and mid vitreous cavity .Intra Cameral / intra vitreal , intra stromal voriconazole injection was given. Double Amniotic membrane overlay was done for persistent epithelial defect. This led to completed healing of infiltrate. The patient showed improvement in vision and was continued on oral acyclovir prophylactically for 6 more months.