Risk factors:
(1) foreign body in the eye
(2) corneal abrasion with plant material
Hemoglobinopathy was not a risk factor for ocular involvement.
Clinical findings:
(1) corneal infiltrate, keratitis, corneal ulcer and/or corneal perforation
(2) ocular pain
(3) eye irritation
(4) decreased visual acuity
(5) conjunctival injection
(6) swelling of the eyelid
(7) hypopyon
(8) endophthalmitis
Laboratory findings:
(1) fungal hyphae in scrapings
(2) positive fungal culture for Pythium insidiosum
Patients respond poorly to topical or systemic antifungal agents including saturated solution of potassium iodide (SSKI). Radical surgery (keratoplasty, evisceration, enucleation) to remove infected tissue may be necessary to control the infection.
