A ring infiltrate may surround the primary lesion, although such infiltrates can also occur in bacterial, viral and parasitic corneal infections. The anterior chamber reaction can be rather severe, out of proportion to the patient's symptoms and corneal findings. Expect to see endothelial plaque formation and hypopyon. Lesions located near the limbus may develop deep neovascularization. A fungal corneal ulcer may mimic the presentation of a bacterial infection.
Yeast infections present a different clinical picture.
They develop more commonly in immunocompromised patients, those with preexisting corneal disease, or those on topical steroids. These infections produce an oval, elevated, plaque-like infiltrate. The surrounding cornea is often edematous, and the edges of the infiltrate tend to be less feathery than with filamentous fungal infections. Satellite lesions rarely develop in yeast infections. Although the history and clinical appearance may strongly suggest fungal keratitis, cultures are necessary to confirm your diagnosis.