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Letters to the Editor

Role of potassium hydroxide preparation in the management of mycotic corneal ulcers

Agarwal, Amit; Agarwal, Rachna1

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Indian Journal of Ophthalmology: Jul–Aug 2012 - Volume 60 - Issue 4 - p 336
doi: 10.4103/0301-4738.98732
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Dear Editor,

This refers to a well-drafted article by Nath et al., published in a recent issue of the Indian Journal of Ophthalmology.[1] We would like to draw attention to a few points. In the presented study, the authors found the presence of fungal elements by 10% KOH smear in only 65.2% cases, which is quite less than our practical experience and from the results of other studies.

Sharma et al.,[2] found fungal filaments in 100% and 81.2% of the corneal scrapings by the KOH method in the two phases of their study, while Gopinathan et al.,[3] found it to be 91% in their study. In most of the private practitioners and smaller centers where culture facilities are not available, KOH smear is the only reliable and easy-to-use diagnostic tool, and it works in 90–95% of the cases.

Secondly, the treatment of perforated fungal ulcers needs to be separated from the ulcers without perforations, as the eye can sometimes be saved only by therapeutic keratoplasty,[4] although in smaller perforations cyanoacrylate glue also works very well.[5]

1. Nath R, Baruah S, Saikia L, Devi B, Borthakur AK, Mahanta J. Mycotic corneal ulcers in upper Assam Indian J Ophthalmol. 2011;59:367–71
2. Sharma S, Silverberg M, Mehta P, Gopinathan U, Agarwal V, Naduvilath TJ. Early diagnosis of mycotic keratitis: Predictive value of potassium hydroxide preparation Indian J Ophthalmol. 1998;46:31–5
3. Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India Cornea. 2002;21:555–9
4. Sony P, Sharma N, Vajpayee RB, Ray M. Therapeutic keratoplasty for infectious keratitis: A review of the literature CLAO J. 2002;28:111–8
5. Garg P, Gopinathan U, Nutheti R, Rao GN. Clinical experience with N-butyl cyanoacrylate tissue adhesive in fungal keratitis Cornea. 2003;22:405–8
© 2012 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow