Corneal Ulcer — Bacterial and Fungal

A 52-year-old farmer from Punjab presents with corneal ulcer following a thorn prick injury 2 weeks ago. Examination reveals a central ulcer with raised, indurated borders, minimal discharge, and satellite lesions. KOH mount of corneal scrapings shows septate hyphae. Regarding fungal corneal ulcers, all of the following are true EXCEPT:

A 52-year-old farmer from rural Maharashtra presents with a 10-day history of painful red eye with photophobia and blurred vision. Slit-lamp examination reveals a central corneal ulcer with raised, infiltrated borders and a hypopyon. The ulcer has a feathery margin and satellite lesions. Which investigation is most appropriate to confirm the diagnosis and guide therapy?

A 38-year-old farmer presents with a 3-day history of severe ocular pain, photophobia, and purulent discharge from the right eye. Slit-lamp examination reveals a central corneal ulcer with stromal infiltration and hypopyon. Gram stain of corneal scrapings shows gram-positive cocci in clusters. What is the drug of choice for empirical topical therapy?

A 58-year-old diabetic woman from Delhi presents with a 10-day history of progressive left eye pain and blurred vision. Examination reveals a 3 mm corneal ulcer with feathery, raised borders, satellite lesions, and a stromal haze. KOH mount of corneal scrapings shows septate hyphae. What is the most appropriate next step in management?

A 52-year-old sugarcane farmer from rural Maharashtra presents with a 2-week history of progressive corneal opacity, pain, and blurred vision in the left eye. He sustained a corneal abrasion from a plant thorn 3 weeks ago. Slit-lamp examination shows a grayish-white stromal infiltrate with feathery borders and minimal anterior chamber reaction. KOH mount of corneal scrapings reveals branching septate hyphae. What is the drug of choice for topical antifungal therapy?