<prompt> A 48 year old diabetic with orbital cellulitis presented with a corneal ulcer. An aqueous tap showed branched hyphae. Diagnosis is -Herpetic ulcerMycotic UlcerBacterial UlcerAnterior staphyloma  <response>: Ans. is b i.e., Mycotic Ulcer Mycotic fungal corneal ulcero The incidence of corneal ulceration due to fungi has increased significantly due to long-term unwarranted use of antibiotic and steroid. The most common mode of infection is injury by vegetative material such as crop leaf, horn, wooden stick. The causative fungus are Aspergillus fumigatus most common, Candida albicans and fusarium.Clinical featureso Symptoms are similar to bacterial comeal ulcers but in general they are less marked than the equal size bacterialulcer.On the other hand signs are very prominent, i.e. signs are more prominent than symptoms, o Following signs can be seen: -i Greyish-white dry looking ulcer with the elevated rolled out feathery hyphate margins.ii Feathery finger like extension into surrounding stroma under intact epithelium.iii A sterile immune ring yellow line of Wesseley.iv Multiple small satellite lesions.v Non-sterile infected hypopyon Pseudohypopyon-Hence penetrated the endotheliumvi Perforation is rare and comeal vascularization is conspicuously absent.Diagnosiso Examination of wet KOH will show:-i Flamentous fungi branched septate hyphae :- Aspergillus fumigatus, Fusarium.ii Non-filamentous yeast like fungi: - Candida.Treatment of fungal corneal ulcero Treatment of comeal fungal ulcer involves:- 1 Specific definitive treatment, and 2 Adjunctive concurrent treatment.1 Definitive treatment: - It includes antifungal drugs: -A Topical antifungals -i For filamentous fungi Aspergillus,fusarium:- Natamycin 5 eye drops drug of choice, Miconazole ointment, Amphotericin B drops.ii For yeast Candida: - Amphotericin B Drug of choice, nystatin, flucytocine.B Systemic antifungals: - May be required in severe cases. Fluconazole or ketoconazole may be used.2 AdjunctiveConcurrent therapy: - This follows the same principles as in any other infectious comeal diseases. Cycloplegic 1 atropine ointment or drop is the DOC should be used to: - i Reduce pain from ciliary spasm; ii Prevent posterior synaechiae; iii Reduce uveal inflammation. Topical steroids enhance fungal replication and comeal invasion and are contraindicated during early therapy of a fungal comeal ulcer. 