A farmer presents with a corneal ulcer with a dry, rough surface, satellite lesions, and feathery borders after a twig injury to the eye. Corneal scraping shows septate hyphae. The drug of choice is:

• A Topical voriconazole 1%
• B Topical amphotericin B 0.15%
• C Topical fluconazole 0.3%
• D Topical natamycin 5% ✓

Explanation

Fungal keratitis (keratomycosis) following vegetative trauma in agricultural workers is most commonly caused by filamentous fungi such as Fusarium and Aspergillus, which produce septate hyphae on microscopy with KOH or calcofluor white staining. Natamycin (pimaricin) 5% suspension is the drug of choice for filamentous fungal keratitis due to its broad activity against Fusarium, Aspergillus, and other molds; it is the only commercially available topical antifungal specifically approved for ophthalmic use.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.