What Causes Fungal Eye Infections?

Eye InjuriesThe most common way for someone to get a fungal eye infection is because of an eye injury, particularly if plant material such as a stick or a thorn1 caused the injury. Some fungi that cause eye infections, such as Fusarium, live in the environment and are often associated with plant material. Fungi can enter the eye and cause infection after an injury.

Eye Surgery
Woman having eye surgery
Less often, infection can occur after eye surgery such as corneal transplant surgery or cataract surgery.
People who have had surgery to replace their corneas (the clear, front layer of the eye) are at higher risk of fungal eye infections. Each year, about 50,000 Americans have a corneal transplant to replace injured or diseased corneas. A small number of people who have this surgery (about 4 to 7 for every 10,000 transplants) develop a fungal eye infection.

From 2007 to 2014, endophthalmitis, or infection of the interior of the eye, became more than twice as common for people with recent corneal transplant surgery.2 In the past, this type of endophthalmitis was most commonly caused by bacteria. However, now fungi (most often the Candida species) cause about two-thirds of infections. CDC is working with partners to understand the reasons for this increase in fungal endophthalmitis following corneal transplant surgery and to find ways to prevent it.

Invasive Eye Procedure
Fungal eye infections could happen after an invasive eye procedure such as an injection. Some infections have been traced to contaminated medical products such as contact lens solution,3 irrigation solution4 and dye5 used during eye surgery, or corticosteroids injected directly into the eye.5 

Fungal Bloodstream Infection
Rarely, fungal eye infections can happen after a fungal bloodstream infection such as candidemia spreads to the eye.

  1. Thomas PA, Kaliamurthy J. Mycotic keratitis: epidemiology, diagnosis and management. Clin Microbiol Infect 2013;19:210-20.
  2. Edelstein, Sean L., et al. Report of the Eye Bank Association of America Medical Review Subcommittee on adverse reactions reported from 2007 to 2014. Cornea 35.7 (2016): 917-926.
  3. Chang DC, Grant GB, O’Donnell K, et al. Multistate outbreak of Fusarium keratitis associated with use of a contact lens solution. JAMA 2006;296:953-63.
  4. McCray E, Rampell N, Solomon SL, Bond WW, Martone WJ, O’Day D. Outbreak of Candida parapsilosis endophthalmitis after cataract extraction and intraocular lens implantation. J Clin Microbiol 1986;24:625-8.
  5. Mikosz CA, Smith RM, Kim M, et al. Fungal endophthalmitis associated with compounded products. Emerg Infect Dis 2014;20:248-56.
  6. Oude Lashof AM, Rothova A, Sobel JD, Ruhnke M, Pappas PG, Viscoli C, et al. Ocular manifestations of candidemia. Clin Infect Dis 2011;53(3):262-8.

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