Asian Journal of Research and Reports in Ophthalmology

Background: Fungal keratitis is a potentially sight-threatening corneal infection for which demographic exposures and causative fungi vary across settings.

Objective: To assess the demographic characteristics, risk factors, clinical presentation and microbiological findings of patients with suspected fungal keratitis at a tertiary eye care centre in Uttar Pradesh.

Methods: This hospital-based observational study enrolled 108 patients between 1 August 2024 and 31 July 2025. Clinical details and potential predisposing factors were recorded. Corneal scrapings underwent direct microscopy with a 10% potassium hydroxide wet mount and culture on Sabouraud dextrose agar, incubated at 25°C and 37°C.

Results: Men accounted for 75% of the sample, and agricultural occupations accounted for 42.6%. Ocular trauma was common, particularly injury from sugarcane leaves (23.1%); 38.9% of patients did not recall preceding trauma. Central corneal involvement occurred in 64.8%, and hypopyon in 46.3%. Fusarium species represented 33.3% of cases, followed by Aspergillus flavus (12%), A. fumigatus (3.7%) and A. niger (2.8%). In 15.7% of patients, microscopy showed septate branching hyphae but culture was negative. Medical healing was reported in 35.2%, and 16.7% underwent therapeutic penetrating keratoplasty.

Conclusion: In this hospital population, fungal keratitis was frequently associated with agricultural exposure, and Fusarium species were the most frequently identified isolates. Direct microscopy and fungal culture provided complementary diagnostic information, supporting timely microbiological assessment.