Aspergillus-induced malignant glaucoma

Cornea. 2007 Jul;26(6):762-3. doi: 10.1097/ICO.0b013e31805fc37b.


Purpose: To report a case of Aspergillus flavus-induced keratomycotic malignant glaucoma.

Methods: A 48-year-old woman presented with a severe corneal ulcer. She had received topical steroids for 10 days before presentation.

Results: Microbiological studies revealed A. flavus as the offending pathogen. Nonresponsive high intraocular pressure with associated shallow anterior chamber was present. With a diagnosis of keratomycotic malignant glaucoma, the patient underwent therapeutic keratoplasty with cataract extraction with posterior chamber wash. However, there was a recurrence of malignant glaucoma in the postoperative period. Patient underwent limited pars plana vitrectomy.

Conclusions: Keratomycotic malignant glaucoma is a rare complication of severe fungal ulcer. We believe that the use of topical steroids in this case probably led to increased fungal penetration, with the formation of a lens-iris fungal mass and subsequent malignant glaucoma. Nonresponse to medical therapy warrants urgent surgical intervention. To the best of our knowledge, Aspergillus-induced keratomycotic glaucoma has never been reported previously. This report also highlights that therapeutic keratoplasty with cataract extraction alone may not be sufficient for management of such cases, and a limited pars plana vitrectomy may be needed.

Publication types

  • Case Reports

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Aspergillosis / complications*
  • Aspergillosis / microbiology
  • Aspergillosis / surgery
  • Aspergillus flavus / isolation & purification*
  • Corneal Ulcer / complications*
  • Corneal Ulcer / microbiology
  • Corneal Ulcer / surgery
  • Eye Infections, Fungal / complications*
  • Eye Infections, Fungal / microbiology
  • Eye Infections, Fungal / surgery
  • Female
  • Glaucoma / drug therapy
  • Glaucoma / etiology*
  • Humans
  • Intraocular Pressure / drug effects
  • Keratoplasty, Penetrating
  • Middle Aged
  • Timolol / therapeutic use


  • Antihypertensive Agents
  • Timolol