Unusual presentation of fungal keratitis with endothelial plaque

Abstract

Fungal keratitis manifests clinically as epithelial ulcer, pseudopodia, corneal immune ring, hypopyon and endothelial plaque.1 It is an uncommon presentation that indicates severe infection with penetration of fungal elements into the anterior chamber.2 A man in his 30s visited the outpatient department following trauma to the right eye with sugarcane leaf 4days ago while working on the farm. He presented with redness, watering, throbbing pain and blurred vision in the right eye. He did not have any comorbidity. The best corrected visual acuity was 6/18. On slit-lamp examination, we noted circumciliary congestion, 6×4mm white stromal infiltration situated paracentrally extending to the periphery at six o’clock with feathery margins, and three satellite lesions peripheral to the lesion. It was associated with 1×2mm endothelial plaque. There was no epithelial defect on fluorescein staining. The surrounding corneal stroma revealed mild keratitis