| Summary: | <b>Purpose: </b> To study the epidemiological characteristics and laboratory diagnosis of fungal keratitis seen at a tertiary eye care referral centre in South India. <b> Methods: </b> A retrospective review of all culture-proven fungal keratitis seen over a 3-year period, September 1999 through August 2002. <b> Results: </b> Fungal aetiology were confirmed in1095(34.4%) of 3183 corneal ulcers. The predominant fungal species isolated was <i> Fusarium</i> spp (471; 42.82%) followed by <i> Aspergillus</i> spp (286; 26%). Males (712; 65.08%) were more often affected (P< 0.0001). A large proportion of the patients (732; 66.85%) were in the younger age group (21 to 50 years). A majority (879; 80.27%) came from rural areas (P< 0.0001), and most patients (709; 64.75%) were farmers (P< 0.0001). Ocular trauma (1009; 92.15%) was a highly significant risk factor (P< 0.0001) and vegetative injuries (671; 61.28%) were identified as a significant cause for fungal keratitis (P< 0.0001). 172 (15.71%) patients had concurrent diabetes mellitus. The sensitivity of 10% potassium hydroxide (KOH) wet mount preparation was higher (99.23%) than Gram-stained smear (88.73%) (P< 0.0001). Incidence of fungal keratitis was higher between June and September. <b> Conclusion: </b> Agricultural activity and related ocular trauma were principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis.
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