A 42 year old diabetic farmer presented with unilateral red eye and blurred vision to the eye OPD.
He complained of gritty foreign body sensation last week after sustaining abrasions on the face while working at his orchard, which progressed to intense burning sensation and photophobia over the week and now blurring his vision.
Ophthalmic Examination and Slit lamp biomicrosopy revealed;
Central shaggy edges ulcer
hyphate margins extending beyond the edge of the ulcer
marked hypopyon
edematous corneal stroma
There were no ring infiltrates and raised lesions.
Corneal scrapings were collected from base and margins of the ulcer under local anaesthetic and send for microbiological examination.
Microbiological Examination.
Direct examination;
with 10%KOH : filamentous fungi identified
CFW (fluorescent stain): flourescing filamentous fungi
Fungal culture onto paired SDA with antibiotics at 25° and 37°C : puffy colonies with pigment on the reverse.
Fungal morphology on LPCB (lacto phenol cotton blue):
Bean shaped/crescent macroconidia