Mahiran Che Daud,¹ Mohtar Ibrahim,¹ Shamala Retnasabapathy^2
1Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, and ²Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

This report is of a patient with Aspergillus flavus sclerokeratitis noted 8 years after pterygium excision. A 61 year-old man with diabetes mellitus was referred to the Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia, with right eye pain and redness for the previous 2 weeks. He had no history of trauma, but had had pterygium excision and cataract surgery performed 8 years previously. Examination of the right eye revealed right nasal scleral necrosis with calcification and a stromal abscess suggestive of fungal keratitis adjacent to the lesion. Corneal scraping revealed Aspergillus flavus. The patient responded well to treatment with topical and oral fluconazole and topical amphotericin B 0.15% and, after 5 weeks, the scleral necrosis had become epithelised, and the stromal abscess and plaque regressed. Early diagnosis is important, and aggressive medical treatment will improve the outcome.

Key words: Aspergillus flavus, Cornea, Eye infections, fungal, Pterygium, Sclera

Asian J Ophthalmol. 2008;10:233-235.