While working on mycotic keratitis in man we isolated a large variety of fungi which are saprophytes abundant in our environment. Most patients give trauma before onset of mycotic keratitis, including trauma due to contact lenses. But in a few cases there is no history of trauma. Use of steroids and antibacerial antibiotics may abrogate the defense mechanism of the eye that may lead to mycotic keratitis. The learned workers may know many factors that may lead to mycotic keratitis or keratomycosis.
There are many risk factors for developing fungal keratitis. Among the most frequent ones are vegetal trauma, contact lens wear, severe dry eye disease (eg., SJS, TEN, OMMP, Sjögren, GVHD); systemic immunosuppression, CA, DM, atopy, prolonged use of topical steroids and broad-spectrum antibiotics, tropical climate.
Plant origin trauma
contact lens
severe dry eye
immune defect
prolonged use of topical steroid
prolonged use of topical antibiotics
after corneal lamellar surgeries
old age
Most of the males are outdoor workers so trauma specially with vegetative matter is the main cause .The other reasons being steroid use and mixed bacterial with fungal keratitis
Filamentous fungal keratitis usually occurs in healthy young males engaged in agricultural or other outdoor work; these fungi do not penetrate an intact epithelium and invasion is secondary to trauma. Trauma is the key predisposing factor, occurring in 40–60% of patients. other reported risk factors include previous ocular surgery, ocular surface disease, previous use of corticosteroids (either topical or systemic) and contact lens use.