AIM: To explore the predisposing factors, population characteristics and clinical features of severe fungal keratitis.

METHODS:The data of 233 cases 233 eyes of severe fungal keratitis in my hospital from January, 2008 to November, 2013 was retrospectively reviewed. The predisposing factors, population characteristics and clinical features were analyzed.

RESULTS: In 233 cases of severe fungal keratitis, the number of male patients was 153(65.7%)and the number ratio of male to female was 1.9:1. The average age of them was(52.7±11.3), and most of them were middle-aged and elderly people living in the rural area(78.1%)and were farmers(66.1%)with low literacy(59.7%). In 233 cases, 188 cases(80.7%)possessed a clear history of ocular trauma, mainly caused by plant-based trauma(60.9%). 90 cases(57.3%)were infected with Fusarium, and 47 cases(29.9%)by Aspergillus. The main treatment of severe fungal keratitis was surgery(87.9%). 83 cases(52.9%)were treated with penetrating keratoplasty, and in Fusarium and Aspergillus infected patients with severe fungal keratitis, 58.4%(80/137)were performed with penetrating keratoplasty. In addition, patients treated with eye enucleation or evisceration, 68.4%(13/19)were infected with Fusarium species.

CONCLUSION: Patients with severe fungalkeratitis in our hospital are mainly elderly male farmers living in rural, because of low economic condition and poor diagnosis consciousness. The main pathogens are Fusarium and Aspergillus species, and the major treatment is penetrating keratoplasty. Most of patients with poor clinical outcomes are infected with Fusarium species.