COVID-19, steroids, and mucormycosis: What an ophthalmologist should know

• DOI: 10.4103/ijo.ijo_1143_21
• Publication Date: 2021-06-25T18:43:02Z
• Authors: Abhishek Tandon; Latika Pandey
• Keywords: Adrenal crisis; Disfigurement

Dear Editor, The landmark RECOVERY (Randomised Evaluation of COVID-19 Therapy)[1] trial published in June 2020 has served as a license to use steroids patients with (coronavirus disease 2019). However, the benefit was specifically shown low-dose, short-duration dexamethasone moderate severe illness, point we certainly seemed have missed. high doses corticosteroids and anti-IL-6-directed strategies led flare-up secondary bacterial fungal infections, mucormycosis being an important one them. With blatant misuse steroids, new cases are coming into light every day, such it becomes for treating ophthalmologist familiarize themselves disease, aiding early diagnosis, that cannot be emphasized enough. Delay recognizing symptoms signs could prove cataclysmic already mortality rate. Sarkar et al.[2] reported four their 10 expired within 1 five had irreversible vision loss, only patient both ocular systemic favorable outcomes. Eyelid swelling, black discoloration, ptosis, proptosis, restricted eye movement, eschar or discharge nasal oral cavity, cranial nerve involvement ominous signs[3] should raise alarms post-COVID-19 patient. Mucormycosis significant impact on patient's standard living therefore clinical suspicion, prompt treatment key alleviate misery ameliorate recovery. There is no biomarker mucormycosis, hence negative galactomannan beta-d-glucan useful pointers rule out other mold infections. Rapid diagnostic methods include KOH (potassium hydroxide) mount, calcofluor stain, biopsy. Because mucor difficult culture, biopsy mainstay diagnosis. Treatment principles antifungal agents, surgical debridement, reversal underlying predisposing factors. Amphotericin B been invasive but renal impairment, posaconazole isavuconazole become alternatives.[4] Financial support sponsorship Nil. Conflicts interest conflicts interest.