About Fungal Conjunctivitis
The most common cause of fungal conjunctivitis is exposure to fungi in the environment. Fungi are present in soil, plants, and water, and can be transmitted to the eyes through direct contact or through contaminated objects like contact lenses or eye makeup.
Non-modifiable risk factors for fungal conjunctivitis are factors that cannot be changed or controlled. These include:
- Eye traumas: Eye traumas, such as injuries or accidents involving the eye, can increase the risk of developing fungal conjunctivitis.
- Surgical interventions on cornea: Previous corneal surgeries can weaken the protective barrier of the eye, making it more likely to get fungal infections.
- Corneal diseases: If someone already has certain eye problems that affect the cornea (the clear front part of the eye), this can weaken the cornea and make it easier for fungi to get in and cause an infection.
- Weak immune system: Certain health conditions or medications that weaken the immune system can make people more likely to get fungal infections.
Modifiable risk factors for fungal conjunctivitis can be influenced or changed. These include:
- Wearing contact lenses: Improper use or maintenance of contact lenses, such as not cleaning them properly or wearing them for extended periods of time, can increase the risk of fungal conjunctivitis.
- Poor hygiene practices: Not washing hands before touching the eyes, sharing eye makeup or cosmetic products, or using expired eye drops can introduce fungi into the eyes and increase the risk of infection.
- Environmental exposure: Spending time in environments with high levels of fungi, such as farms or construction sites, can increase the risk of fungal conjunctivitis.
It's important to note that while these risk factors can increase the likelihood of developing fungal conjunctivitis, not everyone with these risk factors will necessarily develop an infection. Taking preventive measures, such as practicing good hygiene and following proper contact lens care guidelines, can help reduce the risk of fungal conjunctivitis.
Common symptoms of fungal conjunctivitis include:
- Redness or mild irritation in the eye
- Itchiness
- Watery eyes
- Feeling that something is in the eye or a gritty feeling
Other common symptoms that may occur with progression or higher severity of fungal conjunctivitis include:
- Pinkness or redness in the whites of the eye
- A burning or painful sensation in the eye
- Puffy eyelids
- Blurry or hazy vision
- Increased sensitivity to light
- Discharge from the eye, such as pus or mucus, which may cause the eyelashes to stick together
To diagnose fungal conjunctivitis, healthcare professionals may use a combination of examinations, tests, and procedures. These include:
- Personal medical history: The doctor will ask about your symptoms, previous eye conditions, and any recent exposure to potential sources of fungal infection.
- Physical exam: The healthcare professional will examine your eyes and eyelids to look for signs of conjunctivitis, such as redness, swelling, discharge, or changes in the conjunctiva.
- Eye swab: In some cases, the doctor may gently swab the affected eye to collect a sample for laboratory testing. This test helps identify the presence of fungi in the eye.
- Fungal culture: The collected eye swab sample may be sent to a laboratory for fungal culture. This test involves placing the sample on a special substance that helps identify the type of fungus causing the infection.
Additional examinations, tests, and procedures may be performed based upon initial findings or individual factors. These may include:
- Visual acuity test: This test measures how well you can see at various distances and helps assess the impact of conjunctivitis on your vision.
- Slit-lamp examination: A slit-lamp is a specialized microscope that allows the doctor to examine your eyes in detail. It helps identify any corneal involvement or other complications associated with fungal conjunctivitis.
- Fluorescein staining: In some cases, the doctor may use a special dye called fluorescein to evaluate the surface of your cornea. This dye helps highlight any scratches or sores on the cornea that may have been caused by fungal conjunctivitis.
- Intraocular pressure measurement: Increased pressure inside the eye can be a sign of certain types of fungal eye infections. The doctor may use a tool called a tonometer to check this pressure.
The goals of treatment for fungal conjunctivitis are to eliminate the fungal infection, relieve symptoms, and prevent complications.
- Medications commonly used to treat fungal conjunctivitis include:
- Topical antifungal agents: Antifungal eye drops are applied directly to the eye and work by killing or inhibiting the growth of the fungus.
- Oral antifungal medications: These pills are swallowed to kill or inhibit the growth of the fungus.
- Intravenous antifungal medications: These medications are injected to kill or inhibit the growth of the fungus. They are usually used if topical or oral antifungals are not an option or do not clear the fungal infection.
- Surgical intervention:
- In some cases, surgery may be needed, which typically involves a corneal transplant or therapeutic penetrating keratoplasty (TPK).
- TPK replaces a damaged or infected part of the cornea with healthy tissue from a donor to help restore vision and aid in healing.
- These procedures are usually for severe cases, such as when there’s a risk of the cornea tearing or if the infection keeps getting worse despite other treatments.
- The goal of surgery is to restore vision and support healing after the initial infection has been treated.
- In advanced cases where there’s a risk of the eye surface breaking down, and surgical options are limited, temporary procedures like tarsorrhaphy (partially sewing the eyelids together) or creating a protective layer using conjunctival tissue may be used to support the eye structure.
- In some cases, surgery may be needed, which typically involves a corneal transplant or therapeutic penetrating keratoplasty (TPK).
- Self-care and health behavior changes:
- Avoid rubbing or touching the eyes.
- Practice good hand hygiene.
- Avoid sharing personal items like towels or eye makeup.
It's important to note that while over-the-counter eye drops or home remedies may provide temporary relief from symptoms, they are not recommended as primary treatment for fungal conjunctivitis. Always consult with a healthcare professional or an eye specialist for proper diagnosis and appropriate treatment options for fungal conjunctivitis.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.
The natural progression of fungal conjunctivitis can vary depending on the individual and the specific fungal strain involved. In most cases, fungal conjunctivitis tends to resolve on its own within a few weeks to a month with proper treatment.
However, if left untreated or if the infection is severe, complications can occur. Some common complications of fungal conjunctivitis include:
- Corneal ulceration: Fungal infection can cause ulcers to form on the cornea, which is the clear layer at the front of the eye. Corneal ulcers can be painful and may lead to scarring or vision loss if not treated promptly.
- Conjunctival scarring: The conjunctiva is the thin membrane that covers the white part of the eye and the inside of the eyelids. Fungal infection can cause scarring of the conjunctiva, which may affect the normal functioning of the eye.
- Punctate keratitis: This occurs when the upper layers of the cornea become inflamed due to fungal infection. Punctate keratitis can cause discomfort, blurred vision, and sensitivity to light.
Early detection and timely treatment play a crucial role in preventing complications and promoting a faster recovery from fungal conjunctivitis. If you experience symptoms such as redness, itching, discharge, or blurred vision in your eyes, it's important to seek medical attention for an accurate diagnosis and appropriate management of your condition.