Phialophora corneal ulcer.

BACKGROUND

A corneal fungal ulcer which appeared to be quite superficial clinically, was found by histologic examination to unexpectedly involve the full thickness of the cornea.

METHODS

A patient with an apparent superficial corneal fungal ulcer due to Phialophora species was resistant to topical and intravenous antifungal therapy.

RESULTS

Penetrating keratoplasty cured the condition with retention of normal vision with a follow-up of two years.

CONCLUSIONS

If keratomycosis is unresponsive to topical and intravenous antifungal therapy, penetrating keratoplasty may be required to eliminate the infection. Resistance to medical therapy might suggest presence of fungus far deeper in the cornea than suspected clinically.