AIM:To assess the clinical application of confocal microscopy combined with corneal scraping in the diagnosis and treatment of fungal keratitis.

METHODS: Totally 56 eyes of 56 patients with fungal keratitis from our hospital were included. All patients underwent confocal microscopy and cornea scraping for smear microscopy and fungal culture. The diagnostic yield was analyzed.

RESULTS: The positive diagnostic rates of confocal microscopy and cornea scraping were 91% and 54% respectively,whereas in combination the positive diagnostic rate increased to 95%. 44 eyes(79%)were clinically cured with drugs alone while 12 eyes(21%)also required surgery.

CONCLUSION: Confocal microscopy examination is non-invasive, with rapid detection and strong repeatability. When combined with corneal scraping it can be used to improve diagnostic yield and guide clinical therapy.