Fungal Eye Infection Statistics

Fungal keratitis: The exact incidence of fungal keratitis in the general population is unknown, but it’s thought to be more common in warmer climates where the fungi that cause these infections are likely more common in the environment. 1

Exogenous fungal endophthalmitis (fungi enter the eye from outside the body): Endophthalmitis is a very rare complication of eye injury or eye surgery; in the United States, it occurs as a post-surgical complication in approximately 0.1% of all cataract surgeries.2 Furthermore, only a small percentage of these infections are caused by fungi; bacterial endophthalmitis is more common.

Endogenous fungal endophthalmitis (fungi enter the eye as a result of an existing bloodstream infection): Endogenous endophthalmitis is extremely rare and is less common than exogenous endophthalmitis; studies have estimated that only 2 to 15% of all endophthalmitis cases are endogenous. 3 Candida species are the most common cause of endogenous fungal endophthalmitis. 3 An estimated 1% of patients with candidemia develop Candida endophthalmitis. 4

Public health surveillance for fungal eye infections
Fungal eye infections aren‘t reportable, which means that healthcare providers aren’t required to regularly report cases to public health authorities. However, healthcare providers who are concerned about an unusual number of new cases of fungal eye infections should contact their state or local health department.

Outbreaks of fungal eye infections

  • In 2012, CDC, state and local health departments, and the Food and Drug Administration (FDA) investigated a multistate outbreak of Fusarium incarnatum-equiseti species complex endophthalmitis associated with Brilliant Blue-G, a type of dye used during eye surgery, and Bipolaris endophthalmitis associated with eye injections of a steroid called triamcinolone. Both contaminated products came from the same compounding pharmacy. 56 Visit the Emerging Infectious Diseases Journal Volume 20, Number 2—February 2014 web page to read more about this outbreak.
  • In 2006, CDC, state and local health departments, and the Food and Drug Administration (FDA) investigated a large, multistate outbreak of Fusarium keratitis associated with a specific type of contact lens solution, which was later withdrawn from the market. 79 Visit the MMWR Weekly web page to read more about this outbreak.
  1. Srinivasan M. Fungal keratitisexternal icon. Curr Opin Ophthalmol 2004;15:321-7.
  2. Keay L, Gower EW, Cassard SD, Tielsch JM, Schein OD. Post-cataract surgery endophthalmitis in the United States: analysis of the complete 2003 to 2004 Medicare database of cataract surgeriesexternal icon. Ophthalmology 2012;119:914-22.
  3. Keynan Y, Finkelman Y, Lagace-Wiens P. The microbiology of endophthalmitis: global trends and a local perspectiveexternal icon. Eur J Clin Microbiol Infect Dis 2012;31:2879-86.
  4. Oude Lashof AM, Rothova A, Sobel JD, Ruhnke M, Pappas PG, Viscoli C, et al. Ocular manifestations of candidemiaexternal icon. Clin Infect Dis 2011;53:262-8.
  5. Mikosz CA, Smith RM, Kim M, Tyson C, Lee EH, Adams E, et al. Fungal endophthalmitis associated with compounded productsexternal icon. Emerg Infect Dis 2014;20:248-56.
  6. CDC. Notes from the field: Multistate outbreak of postprocedural fungal endophthalmitis associated with a single compounding pharmacy—United States, March-April 2012. MMWR Morb Mortal Wkly Rep 2012;61:310-1.
  7. Chang DC, Grant GB, O’Donnell K, Wannemuehler KA, Noble-Wang J, Rao CY, et al. Multistate outbreak of Fusarium keratitis associated with use of a contact lens solutionexternal icon. JAMA 2006;296:953-63.
  8. CDC. Update: Fusarium keratitis—United States, 2005-2006. MMWR Morb Mortal Wkly Rep 2006;55:563-4.
  9. CDC. Fusarium keratitis—multiple states, 2006. MMWR Morb Mortal Wkly Rep 2006;55:400-1.