The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration.

A five-year-old boy suffered from a penetrating left eye injury from a graphite pencil while playing at home. He presented with severe pain and loss of vision. The best corrected visual acuity was 6/6 in his right and 5/60 in his left eye. Anterior segment examination revealed blepharospasm, lid edema, conjunctival congestion, small graphite pencil with a wooden fragment embedded in the anterior chamber with an entry wound in the cornea, anterior chamber moderate depth with Seidel's test positive (Figures 1 to 3). With a guarded visual prognosis, the patient was advised to undergo removal of the intraocular pencil with suturing of the corneal tear under general anesthesia (Figures 4 and 5). Consequently, there is less chance of injury to the eye itself. The child developed a post-traumatic focal cataract but as the central visual axis was clear he was able to read 6/6. Ocular injuries with graphite pencil lead are very rare. Graphite pencils are made of graphite and clay, mixed with animal oils and fats, with a wooden surround. 1 Although graphite pencils are frequently used in classrooms and homes by young children, there is little literature on injuries to the eye and adnexa with these pencils. The commonly injured sites are the eyelids and orbit, 2,3 probably due to the fact that when an

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Neoscytalidium dimidiatum is a plant pathogen that rarely causes human infection. Very few cases of ocular infection have been reported. We report a case series of three patients who presented with keratitis caused by it. The culture showed effuse, white-to-grayish colonies with yellow-to-deep orange colony reverse. Chains of arthroconidia typical of Neoscytalidium were seen on staining with lactophenol cotton blue. Two patients responded to topical antifungal treatment while one needed therapeutic keratoplasty. Hence, early diagnosis and intensive antifungal treatment are essential for successful healing in mycotic keratitis caused by Neoscytalidium species.