The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
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Corneal ulcer in a
palm worker
Photo by Dr. Ngo Chek Tung
A 24 year-old Indonesian
oil palm plantation worker presented to the eye department with a 6-day
history of painful left eye. He gave a history of left corneal abrasion from
the leave of oil palm while at work. Examination showed a dense corneal
ulcer with feathery edge suggestive of fungal keratitis. He was admitted for
intensive topical amphotericin B and fluconazole and systemic oral
fluconazole while awaiting for the fungal culture result in addition to
intensive gentamicin and ceftazedine. The ulcer
responded well to treatment. However, the culture returned 3 days later
showed only Pseudomonas spp. The oral fluconazole was stopped but the
other anti-fungal agents were continued because of the clinical appearance.
Right dense corneal ulcer with
hypopyon.
Close-up view shows feathery edges
suggestive of fungal keratitis.
Improved ulcer appearance with
intensive anti-fungal and antibiotics regime.
