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Pathology Quiz 6
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Mehran Afshari, M.D. | Massachusetts Eye and Ear Infirmary, Harvard Medical School
Wasee Polcharoen, M.D. | Massachusetts Eye and Ear Infirmary, Harvard Medical School

August 13, 1998
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Figure 1
 Histopathology of cornea (Periodic-acid Schiff stain, original magnification x 250)
Questions and Answers
1. What is the diagnosis?
Answer: Fungal keratitis (Mycotic corneal ulcer)

2. What are the predisposing factors for developing this lesion?
Answer: History of trauma particularly to vegetable matter or soil, a chronic preexisting ocular surface disorder, systemic and topical immunocompromise, and prolonged steroid use.

3. What are the stains used for demonstration of this lesion in paraffin fixed tissue?
Answer: Gomori’s methenamine silver (GMS) stain in which the fungi stains black against a green background, and Periodic acid Schiff (PAS) stain in which the fungi stains vividly purple against a blue-gray background.

4. How do we treat this lesion?
Answer: Anti-fungal medications. Penetrating keratoplasty is usually indicated for extensive lesions.

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