Current efforts and the potential of nanomedicine in treating fungal keratitis

Fungal infection of the cornea (mycotic or fungal keratitis, keratomycosis) is a serious disease that can lead to loss of vision if not diagnosed and treated promptly and effectively. The pharmacological approach of management of fungal keratitis involves administration of antifungal agents. However, owing to the physiologic constraints of the eye, only a few drugs define sufficient bioavailability. The need for more potent antifungals with increased activity, shorter treatment durations and fewer adverse effects simultaneously stimulates the drive for the development of new antifungal agents with a broader spectrum and improved pharmacokinetic profile, and the development of advanced novel formulations for drug delivery that could increase drug bioavailability while reducing the adverse effects. In this article, the efforts and scientific potential of these two avenues are discussed. First, the classical and novel antifungal drugs are presented. Second, the classical formulations are compared with the advanced novel nanomedicines, and their potential clinical applications are discussed.