Stromal infiltrates have minimal cellular reaction and rough texture . The epithelial surface looks dry, gray and may be either above the level of the corneal surface or ulcerated. Sometimes pigmented fungal elements can be recognized Satellite lesions or multifocal microabscesses are also seen.
Fungal keratitis is a serious condition that requires prolonged treatment and close follow-up.
Surgery may be necessary, depending upon the degree of damage to the eye. The lesions typically advance into the deep stroma of the cornea and contain hyphae that are 3-4 um in diameter with some swollen cells. The fungus usually develops throughout the entire depth of the cornea. It is not uncommon for hyphae to be only in the middle and deeper layers. Early in the disease, there is an acute suppurative inflammatory process accompanied by coagulative necrosis.