Fungal Keratitis and Ocular Surface Squamous Neoplasia in a HIV Positive Patient

Aim: We report a case of fungal keratitis and Ocular Surface Squalous Neoplasia (OSSN) occurring in a HIV positive patient. Method: A 32-year-old female patient presented with a non-healing ulcer, which was diagnosed as fungal keratitis. On examination her ocular surface also revealed OSSN on the nasal bulbar conjunctiva. Serological investigations revealed HIV positive status with CD 4 counts of 61 cells/μl. Patient was treated for fungal keratitis with topical antifungals and also underwent excision biopsy of OSSN which was reported as conjunctival intraepithelial neoplasia. The ulcer showed significant response to topical medication only after the commencement of Anti-Retroviral Therapy (ART). Conclusion: This case emphasizes on the importance of a thorough ocular examination to rule out associated ocular conditions and investigations to rule out immunosuppressive status in a non-healing ulcer.