Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors.

中文翻译：

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眼科真菌病的当前观点。

真菌可能会感染角膜，眼眶和其他眼部结构。镰刀菌属，曲霉属，念珠菌属，皮肤病真菌和Scedosporium占主导地位。通过识别典型的临床特征以及直接在显微镜下检测刮伤，活检标本和其他样品中的真菌，有助于诊断。文化证实诊断。也可能需要组织病理学，免疫组织化学或基于DNA的检测。发病机理涉及药物（侵袭性，产毒性）和宿主因素。一旦做出诊断，便开始进行特定的抗真菌治疗。通过各种途径的两性霉素B是威胁生命和严重眼科真菌病的主要治疗方法。外用那他霉素通常是丝状真菌性角膜炎的首选，外用两性霉素B是酵母性角膜炎的首选。日益，三唑伊曲康唑和氟康唑正在作为眼科真菌病的治疗选择进行评估。单独的药物治疗通常不足以治疗由于镰刀菌属，桔梗和臭腐霉引起的侵袭性真菌眼眶感染，巩膜炎和角膜炎。手术清创术对眼眶感染至关重要，而对于其他对药物治疗无反应的感染，可能需要进行各种外科手术。在大多数眼科真菌病中禁忌使用皮质类固醇。因此，正在寻求其他方法来控制炎性组织损伤。眼科手术后，艾滋病患者以及由于使用各种眼用生物材料而引起的真菌感染是眼真菌病的独特子集。未来的研究需要关注快速发展，