In suppurative keratitis presenting as a corneal ulcer, the identification of fungal hyphae on corneal smear defines a specific clinical scenario that requires a targeted management approach — one that differs substantially from bacterial keratitis protocols.
Fungal hyphae identified on corneal smear in the setting of an active suppurative corneal ulcer.
Management is centred on intensive topical antifungal therapy administered at a high frequency. Adjunctive agents addressing pain and intraocular pressure are incorporated where clinically indicated.
Preparations containing steroids are contraindicated in this setting.
The full regimen — including specific agent selection, dosing schedule, and decision criteria — is available in the structured protocol below.
Success is assessed by slit-lamp examination on a defined schedule looking for evidence of ulcer improvement. Failure to improve by the specified review point indicates the need for escalation or specialist referral.