Abstract: In recent years, the development of medicine and related disciplines has provided a new prospect for the treatment of fungal keratitis (FK). In terms of drugs, it mainly focuses on the development of safe and effective antifungal drugs such as acrylamide, echinocandins, antimicrobial peptides and their derivatives. The study of FK immune mechanism provides a theoretical basis for the application of immunosuppressants. In addition, the combine of ocular drug delivery system and antifungal drugs can promote the corneal permeation of drugs, and the effectiveness has been verified by FK animal model, some complexes, such as fluconazole liposomes, have good effects. In terms of FK surgery, early surgery,  the pathogen mainly growing horizontally, slight infiltration with effective antifungal drugs are of great significance to improve the success rate of lamellar keratoplasty. At the same time, intrastromal injection of antifungal drug, corneal collagen cross-linking technology, excimer laser technology highlight their respective advantages in FK patients with early infection, slight infiltration or no response to antifungal drug. In the future, with the continuous development and application of effective antifungal drugs for ophthalmic preparations, the improvement of corneal surgery technology and the cooperation of multiple disciplines, the therapeutic effect and prognosis of FK are expected to be greatly improved.(Int Rev Ophthalmol, 2022, 46: 253-260)

Key words: fungal keratitis, antifungal agents, surgery, combined therapy