Successful Medical Management of Pigmented Fungal Keratitis Following Vegetative Trauma

ABSTRACT: Fungal keratitis remains a frequent cause of corneal morbidity in tropical regions, particularly after trivial trauma involving plant material. Dematiaceous fungi constitute a smaller subgroup of filamentous organisms but may present with characteristic pigmentation over the corneal lesion. A middle-aged woman with controlled diabetes who developed pain and visual blurring after minor ocular trauma came to the ophthalmology outpatient department. Slit-lamp examination showed a paracentral ulcer with feathery margins and a brownish plaque. Direct microscopy confirmed septate pigmented hyphae. Following superficial keratectomy and intensive topical antifungal therapy, the infection resolved without any need for keratoplasty. This case illustrates that early suspicion and timely medical management can successfully control selected cases of dematiaceous fungal keratitis.