History
A case of fungal keratitis caused by Aspergillus was first described by Theodor Leber in 1879, in a 54 year old farmer who injured his eye. Society and culture
The loss of vision with fungal keratitis can be quite disabling in terms of economic impact and social consequences. Many people come with fungal keratitis in the only eye and thus become blind due to the disease. The lack of education and proper eye protection in such cases is evidently responsible for their plight. Notable cases
Recently, one particular product, ReNu with MoistureLoc brand of soft contact lens solutions made headlines regarding a report from the United States Centers for Disease Control and Prevention suggesting an increased incidence of a specific type of fungal keratitis (Fusarium keratitis) in people using Bausch & Lomb products. Bausch & Lomb subsequently suspended, then recalled, shipments of one particular product, ReNu with MoistureLoc. References


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Some acquired conditions may share some features with EME and should be differentiated from it. These include hypoxic-ischaemic encephalopathy, central nervous system infections, acute metabolic disturbances or acute vascular events. Mechanism
Pathology results in EME consist of multifocal changes in white matter, imperfect lamination of the deep cortical layers, astrocytic proliferation, and demyelination. Diagnosis
Electroencephalogram (EEG) is usually characterized by a burst suppression pattern. Subsequently it may transition to hypsarrhythmia, a chaotic pattern on EEG, or other severely abnormal EEG patterns. Neuroimaging is useful in assessing a possible underlying structural causality that might cause EME. MRI findings depend on the underlying etiology and may be normal or not at diagnosis. Prevention
Early identification of metabolism error defects is very essential in prevention as the traditional antiepileptic drug are usually not very effective, proper treatment aiming to the conditions can prevent neurological worsening. Genetic counselling is critical given the high prevalence of genetic mutations and early genetic testing also helps to avoid unnecessary procedures and unsuccessful treatment. The families who are at risk, prophylactic treatment is suggested as it may stop the seizure and help in recovering the neurodevelopmental consequences. Management
Antiepileptic drugs are used to treat EME, but it is difficult to control seizures with anti-epileptic drugs alone. Phenobarbital, valproate, pyridoxine, zonisamide, and benzodiazepines have all been used but with inadequate usefulness in seizure control. Some patients show favorable response to sodium channel agents, often at high dose. There are various means to add on the treatment when seizures are resistant. A ketogenic diet can be useful in controlling seizures.