Antifungal Eye Drops

Evidence Based
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What Are Antifungal Eye Drops?

Fungal eye infections are rare. However, they can be serious and require healthcare treatment. Most of the time, treatment includes antifungal eye drops, ointments, and pills.

Fungal eye infections occur in one of two ways:

  • Keratitis. An infection of the cornea
  • Endophthalmitis. An infection of the inside of the eye

The most common types of fungi that cause ocular infections include:

  • Fusarium. Found in soil and on plants
  • Aspergillus. Found in indoor and outdoor environments
  • Candida. Yeast that lives on human skin and the protective lining inside the body called the mucous membrane

Antifungal eye drops are part of the treatment regimen for all of these types of infections. The most commonly prescribed antifungal eye drops include Amphotericin B, natamycin, fluconazole, voriconazole, and ketoconazole.

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When Are They Prescribed?

Doctors prescribe antifungal eye drops to treat eye infections caused by fungus. They consider the following when diagnosing and treating the infection:

  • Type of fungus
  • Severity of infection
  • Part of the eye affected

In addition to eye drops, a patient with a fungal eye infection might also take oral antifungal medication or be given an antifungal injection into the eye. A surgical procedure such as penetrating keratoplasty, which is a corneal transplantation procedure, might be needed in rare instances when an infection is serious and poses a risk of causing permanent damage to the eye.

Most treatment regimens for fungal infections take several weeks or months to resolve the issue.


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Exposure to fungus puts you at risk for developing a fungal eye infection. Symptoms can arise unexpectedly, especially if you wear contact lenses. Fungal eye infection symptoms are similar to the symptoms of other types of eye infections, including bacterial infections, and include:

  • Pain
  • Redness
  • Discharge
  • Blurred vision
  • Sensitivity to light
  • Excessive tearing

If you have any of these symptoms, call your eye doctor right away. If you wear contact lenses, remove them immediately. Fungal eye infections are very rare, but if they aren’t treated, they can become serious and result in permanent vision loss or blindness. 

Different fungi can cause infections in the eye, including:

  • Fusarium
  • Candida
  • Aspergillus
  • Curvularia

Your doctor is likely to recommend an antifungal therapy that includes antifungal drugs and antimicrobial treatment. Fungal infections often take a significant amount of time to heal and can damage the cornea if left untreated. The only way to ensure the infection is treated properly is to use antifungal agents made with a formulation of materials that kill the fungus. 

Types of Antifungal Eye Drops

Prescription

There are several types of prescription antifungal eye medications for the treatment of fungal keratitis and other fungal eye infections.

Natamycin eye drops treat infections involving the outer layer of the eye, particularly those caused by fungi such as Aspergillus and Fusarium.

Deeper infections usually require treatment in addition to drops. This includes topical Natamycin paired with other antifungal medications such as:

  • Amphotericin B
  • Fluconazole
  • Vfend (voriconazole)
  • Econazole

These are oral or intravenous medications or are topical medications placed directly into the eye or the skin surrounding the eye.

Rare instances in which the infection doesn’t heal might require surgery.

Over-The-Counter 

Remember, fungal eye infections can be very serious. It’s important to consult with your doctor before using an OTC product. A fungal eye infection puts you at risk for blindness if not treated properly.

It’s essential that your doctor examine your eye and determine the location of the infection and assess your overall eye health.

To diagnose a fungal eye infection, your doctor will examine your eye. He or she might also take a small sample of tissue or fluid from your eye. This is not painful, and it does not damage your eye.

Side Effects Antifungal Eye Drops

Antifungal eye drops are safe and effective, but side effects occur. The most common side effect is mild irritation or discomfort.

Serious side effects could indicate an allergic reaction to the medication. Contact your doctor if you experience any of the following after using Natamycin or any other type of antifungal drug or topical medication:

  • Rash
  • Swelling
  • Itching
  • Reaction felt in the face, throat, or tongue
  • Dizziness
  • Breathing difficulty

Despite the discomfort caused by antifungal eye drops, doctors believe the benefits outweigh the risk. You should never stop using medication without first consulting your doctor. If you believe the side effects you experience using eye drops is intolerable, speak to your doctor.

Which Antifungal Eye Drops Are Best For You?

Your doctor will determine which antifungal eye drops are best for you based on the infection, the intensity of the infection, and the part of your eye affected by the infection. Fungal eye infections are rare, but they can cause serious harm to your vision.

Most fungal eye infections, including fungal keratitis, are the result of an injury. For example, if your eye is scratched or scraped by a stick, it can cause fungus to linger in your damaged eye and lead to an infection. However, anyone can get a fungal eye infection. The most common causes of fungal eye infections include:

  • Eye injury, particularly from perforation by plant material like a thorn or stick
  • or similar risk factors in nature
  • Eye surgery (most commonly corneal transplant surgery or cataract surgery)
  • Chronic eye diseases that involve the surface of the eye
  • Contact lenses, especially if you sleep in them
  • Exposure to contaminated medical products
  • Fungal bloodstream infection
  • Use of corticosteroids
  • Weakened immune system
  • Diabetes

Most fungal infections, including infectious keratitis and mycotic keratitis are treatable, but it’s important to see an ophthalmologist as soon as possible. There is a risk of permanent damage to the anterior chamber, the stroma or stromal tissue, the epithelium of the eye, or other intraocular components or affect your visual acuity if infections are left untreated. 

A thorough ophthalmology exam ensures proper diagnosis and treatment of the problem in a timely manner. 

Your susceptibility to an eye infection is higher if you wear contact lenses or spend a lot of time outdoors.

All fungal eye infections must be treated with antifungal medication. An infection will not get better unless it is treated. Treatment might take weeks or months to complete. Deeper infections might require multiple treatments and more time to heal than surface infections. In addition to antifungal drops, your doctor might prescribe oral or intravenous medication.

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