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Br J Ophthalmol 2004;88:1227 doi:10.1136/bjo.2004.047423
  • Letter

The role of corticosteroids in fungal keratitis: a different view

  1. V Peponis,
  2. J B Herz,
  3. H E Kaufman
  1. Louisiana State University, 2020 Gravier Street, Suite B, New Orleans, LA 70112, USA
  1. Correspondence to: Dr Vasileios Peponis Louisiana State University, 2020 Gravier Street, Suite B, New Orleans, LA 70112, USA; pepbasyahoo.com
  • Accepted 31 March 2004

Fungal infections of the cornea continue to be an important cause of ocular morbidity.1

This report describes a situation which occurs in clinical practice in patients with misdiagnosed fungal ulcers who are treated with a combination of topical steroids and antibiotics drops. A common strategy when these patients are finally diagnosed with fungal keratitis is to switch to antifungal agents and discontinue the corticosteroids. We have recently seen two patients with fungal keratitis who demonstrated severe inflammation and corneal necrosis after the abrupt discontinuation of corticosteroids.

Case 1

A 32 year old woman with a corneal transplant in her right eye was referred …

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