Antifungal eye drops are a specialized medication prescribed to treat fungal infections on the surface of the eye. Unlike over-the-counter drops for redness or dryness, these are potent, prescription-only medicines designed to eliminate harmful fungi. They are a primary treatment for serious conditions that can threaten vision by targeting the microorganisms causing the infection.
Conditions Treated by Antifungal Eye Drops
The most common condition requiring antifungal eye drops is fungal keratitis, an infection of the cornea, the clear front part of the eye. This infection often occurs after an eye injury, particularly from plant matter like a stick or thorn, which can introduce fungi into the corneal tissue. Individuals who wear contact lenses or have a compromised immune system also have a higher risk.
Symptoms of fungal keratitis include significant eye pain, persistent redness, and blurred vision. A person with this infection might also experience extreme sensitivity to light (photophobia) and excessive tearing or discharge. While other fungal eye infections can occur, keratitis caused by fungi like Fusarium and Aspergillus is the main reason these drops are administered.
Diagnosis involves a healthcare professional taking a small sample from the cornea to identify the specific fungus. This confirmation guides treatment, as different fungi respond to different medications. Prompt diagnosis and treatment are necessary to prevent complications and preserve vision.
Types of Antifungal Medications
There is a limited number of commercially produced, FDA-approved antifungal eye drops. The most widely recognized is a 5% Natamycin suspension, often considered the first-line treatment for superficial keratitis caused by fungi like Fusarium. Natamycin works by disrupting the fungal cell wall, leading to the fungus’s death, and it adheres well to the corneal surface but does not penetrate deeply into eye tissue.
For infections that are deeper or caused by fungi resistant to Natamycin, ophthalmologists use compounded antifungal eye drops. These are not mass-produced but are specially prepared by a compounding pharmacy. A pharmacist dilutes an intravenous antifungal medication into a solution suitable for topical eye use, allowing for a broader range of medications.
Commonly used compounded agents include Amphotericin B and Voriconazole. Amphotericin B is effective against yeasts like Candida but has poor corneal penetration if the surface epithelium is intact. Voriconazole is a newer agent with a broad spectrum of activity and better penetration into the eye, making it an option for more severe infections.
Proper Application Technique
Correct application is necessary for treatment success, as dosing can be intensive and sometimes required every hour. Before starting, wash your hands thoroughly with soap and water. If the medication is a suspension, it must be shaken well before each use to ensure the drug is evenly distributed.
To apply the drop, tilt your head back and look up. With one hand, gently pull down your lower eyelid to form a small pocket. Hold the dropper bottle with your other hand over the eye. Be careful not to let the tip touch your eye, eyelid, or any other surface to avoid contamination.
Squeeze the bottle to release a single drop into the pocket of the lower eyelid. After the drop is in, close your eye gently for one to two minutes to allow the medication to be absorbed. Do not blink excessively or squeeze your eye shut, as this can push the medication out. If you use more than one type of eye drop, wait at least five minutes between applications.
Potential Side Effects and Treatment Expectations
Upon applying the drops, it is common to experience mild and temporary side effects. Many people report a stinging or burning sensation immediately after the drop enters the eye, along with some redness or irritation. These feelings usually subside within a few minutes.
Treatment for fungal eye infections is often a long process, lasting for several weeks or even months. The infection can be stubborn, so consistent application of the drops as prescribed is necessary for the medication to be effective. Patients should be prepared for numerous follow-up visits with their ophthalmologist to monitor progress.
While mild discomfort is expected, certain side effects warrant a call to your doctor. If you experience worsening eye pain, a significant change in vision, or signs of an allergic reaction like swelling of the eyelids, seek medical advice promptly. These could indicate that the infection is not responding to treatment.