Fungal scleritis after cataract surgery. Successful outcome using itraconazole.

We report the development of fungal scleritis in a 53-year-old man after uncomplicated cataract surgery. Histopathology and culture identified the organism as Aspergillus flavus. Clinically, the patient worsened on treatment with oral ketoconazole and topical amphotericin B with progression of multifocal scleral nodules and necrosis. Resolution of inflammation was achieved using oral itraconazole, a new triazole antifungal agent. The patient achieved 20/15-2 visual acuity and remains free of symptoms and signs for greater than 2 years after discontinuation of all treatment.