Successful Management of Candida Fungal Keratitis in an Elderly Patient Using Amphotericin B: A Case Report

Fungal keratitis is a challenging ocular infection, particularly in patients with predisposing factors such as diabetes mellitus and prior ocular surgery. We present the case of an elderly man with a history of penetrating keratoplasty and insulin dependent diabetes who developed Candida keratitis in his right eye. Initial treatment with topical natamycin was started following positive fungal scrapings, but due to supply shortages, therapy was transitioned to topical amphotericin B combined with chlorhexidine. Despite the recognised limitations of amphotericin B, including poor corneal penetration and potential toxicity, the patient’s infection resolved successfully with this regimen. This case highlights both the efficacy of natamycin as first-line therapy and the potential of amphotericin B as a valuable second-line option when standard treatment is unavailable. It underscores the importance of early diagnosis, aggressive antifungal therapy, and flexibility in adapting management strategies to resource limitations. Further studies are warranted to optimise antifungal treatment protocols and improve outcomes in fungal keratitis.