Fungal Keratitis: Clinical Presentations, Mechanism and Management Strategies

Fungal keratitis (FK) is a common cause of blindness in tropical and subtropical regions and is caused mainly by infections caused by filamentous fungi such as the Aspergillus genus. The diagnosis and recovery of FK are complex compared to other ocular diseases. Owing to the anatomy and psychological properties of the cornea, it is difficult for ocular drugs to penetrate the cornea and achieve therapeutic concentrations. In the past 20 years, the clinic has used the traditional medications natamycin, voriconazole, and amphotericin B as first-line treatments. However, the effectiveness of conventional topical antifungal drugs is limited by the cornea's barrier, tear drainage, and challenges in drug penetration and bioavailability. Therefore, novel therapies or drug delivery systems to improve the treatment of FK are urgently needed. In this review, we discuss and summarize the progress of some promising antifungal management methods.