Bipolaris keratitis following photorefractive keratectomy: Case report

INTRODUCTION: Fungal keratitis is an uncommon condition that can occur after ocular surgery or trauma to the eye. Some cases have been reported after corneal refractive surgery. Most cases of keratitis following refractive surgery are due to gram-positive bacteria. However, there are a few reports in the literature of fungal and protozoal infections. CASE PRESENTATION: A 29-year-old healthy male developed fungal keratitis Five days following photorefractive keratectomy. CLINICAL FINDINGS AND INVESTIGATIONS: The patient was admitted to the hospital, corneal scraping was performed and sent for staining and routine cultures. A corneal swab was also performed and sent for polymerase chain reaction (PCR). On day 10 post-admission, the fungal culture was positive for Bipolaris. INTERVENTION AND OUTCOME: Intensive topical antifungal drops were started initially then tapered when clinical improvement was evident. The patient had good final outcome with preservation of good vision and free of symptoms six months following the infection. RELEVANCE AND IMPACT: Fungal keratitis following corneal refractive surgery is rare. However, it is an infection that can potentially lead to poor outcomes if appropriate management is delayed. Therefore, a high index of suspicion is required especially when multiple risk factors is present.