Abstract / Summary
Abstract Background To evaluate the trend of Candida keratitis during the COVID-19 and post-COVID years and to assess the contribution of systemic and local immunosuppression or COVID as potential risk factor. Main text This retrospective study reviewed electronic medical records of patients diagnosed with Candida keratitis at a tertiary eye care center at Bhubaneswar between January 2020 and August 2025. As per institutional protocol for investigation of microbial keratitis, corneal scrapings were collected from all patients and subjected to direct microscopy and culture for bacteria, fungi and Acanthamoeba . Corneal scraping from 6,294 keratitis patients were received during study period, of which 63 (1.0%) were diagnosed with Candida keratitis with smear/ culture or both. The data distribution includes 0.3% (3/997 total cases) in 2020, 0.5% (5/1003 total cases) in 2021, 1.6% (16/1,019 total cases) in 2022, 1.4% (17/1238 total cases) in 2023, 1.2% (15/1270 total cases) in 2024 and 0.9% (7/767 total cases) in 2025. We found 26 (41.3%) patients having history of earlier immune suppression either systemically or locally suffered from Candida keratitis while 37 (58.7%) patients not having any history of systemic/ local immune suppression also suffered from Candida infection. Conclusion Candida keratitis demonstrated a rising trend in 2022–24 compared to 2020 and 2021 followed by a decline in 2025. More than half of the patients had no history of any systemic or local immunosuppression, suggesting that, COVID-19-related immune dysregulation might have contributed for rise in Candida keratitis during post-COVID period.