Fluconazole in the management of fungal ocular infections.

The number of fungal infections has increased dramatically, and those involving the eye pose a serious problem and treatment challenge to practicing physicians. Despite the overall effectiveness of conventional treatment with amphotericin B, there are several well-recognized disadvantages associated with this drug. The topical agent natamycin, although effective against the filamentous fungi, is less effective against Candida species. Ketoconazole, an effective broad-spectrum, oral antifungal, possesses a better safety profile than amphotericin B, but is also associated with potential toxicity and drug interactions. The ongoing search for improved antifungal compounds led to the development of fluconazole. This review article focuses on fluconazole in the treatment of patients with fungal infections of the eye. In addition to its proven effectiveness and safety in patients with various mycoses, the pharmacokinetic profile of fluconazole confers many advantages including diffusion into ocular tissue. A number of reported cases document the effectiveness of this triazole in human ocularmycoses without the occurrence of significant side effects.