Report of two cases

Fungi are a large group of plant-like micro-organisms, which grow in filaments or "hyphae", and intertwine in a mat-like growth called a mycelium. Reproductive bodies or spores are produced from the colony or mycelium. Ocular fungus was described by the early mycologists, including Leber (I879), who first reported the invasion of the cornea by Aspergillus causing hypopyon ulcer, and Gilchrist (I896), who described ocular involvement in blastomycosis. Ophthalmological research in fungus diseases began in the early 20th century, and interest has recently been renewed by discoveries in the field of antibiotic medicine and the development of cortisone and allied hormonal derivatives. Hammeke and Ellis (I960) surveyed the fungi of the conjunctival sac, and in cultures from 520 eyes found fungi in 10 3 per cent. of adults, 5.0 per cent. of children, and oi per cent. of infants. Williamson, Gordon, Wood, Dyer, and Yahya (I968) isolated fungi from 2 9 per cent. of healthy conjunctival sacs, and from I3 3 per cent. of patients with Sj6gren's syndrome (the isolates included Candida albicans and C. parapsilosis). The majority offungus infections arise on the skin, which constantly receives debris from the air. Ringworm infections (tinea capitis, tinea barbae, tinea glabrosa, tinea cruris, and dermatophytosis) may involve the eyelids. Bedell (1946) reported a corneal ulcer due to cephalosporium (related to Trichophyton gypseum) successfully treated with potassium iodide. Ocular blastomycosis frequently involves the lids, leading to scarring and distortion, with a liability to corneal ulceration. Theodorides and Koutrolikos (1953) reported four cases of blastomycosis of the conjunctiva. Schwartz (I931) described the only known case of metastatic infection reaching the eye from a generalized blastomycosis. Streptothricosis conjunctivae (actinomycosis) commonly causes concretions in the canaliculi, and nodular granulations in the conjunctiva as well as corneal ulcers have been described. Actinomycosis is known to invade the orbit and eye from the sinuses and also from the jaw after dental extraction. Verhoeff (I924) reported the presence of actinomycosis after cataract extraction in both eyes, as well as by metastasis from an infection in which the fungus was isolated from the heart valves. Fuchs (I9I9) also found the fungus in enucleated eyes after cataract extraction. Nocardia asteroides experimentally implanted in the eye by McCarthy, Kennedy, and Hazard (I959) caused granulomata and microabscesses similar to the conglomerate tubercle.