Fungal keratitis is a severe corneal infection caused by fungi, primarily affecting individuals with compromised corneal integrity. It is a leading cause of ocular morbidity, especially in tropical and subtropical regions. Common pathogens include Aspergillus, Fusarium, and Candida, which account for 70% of fungal keratitis cases. Diagnosis involves microscopic examination, culture, and molecular techniques like PCR and metagenomic sequencing. Early and accurate diagnosis is crucial for effective treatment, which often includes topical antifungal agents such as natamycin and voriconazole. Combination therapy is more effective than monotherapy. Antifungal susceptibility testing helps guide treatment. Newer methods like in vivo confocal microscopy (IVCM) aid in early detection. Treatment options include topical and systemic antifungals, targeted drug delivery, nanoparticles, therapeutic contact lenses, photodynamic therapy, and surgical interventions like therapeutic penetrating keratoplasty (PK). Surgical intervention is necessary in severe cases, though it carries risks like graft rejection and re-infection. Advances in diagnosis and treatment have improved outcomes, but challenges remain in managing refractory cases. Multidisciplinary approaches are essential for optimal management of fungal keratitis.Fungal keratitis is a severe corneal infection caused by fungi, primarily affecting individuals with compromised corneal integrity. It is a leading cause of ocular morbidity, especially in tropical and subtropical regions. Common pathogens include Aspergillus, Fusarium, and Candida, which account for 70% of fungal keratitis cases. Diagnosis involves microscopic examination, culture, and molecular techniques like PCR and metagenomic sequencing. Early and accurate diagnosis is crucial for effective treatment, which often includes topical antifungal agents such as natamycin and voriconazole. Combination therapy is more effective than monotherapy. Antifungal susceptibility testing helps guide treatment. Newer methods like in vivo confocal microscopy (IVCM) aid in early detection. Treatment options include topical and systemic antifungals, targeted drug delivery, nanoparticles, therapeutic contact lenses, photodynamic therapy, and surgical interventions like therapeutic penetrating keratoplasty (PK). Surgical intervention is necessary in severe cases, though it carries risks like graft rejection and re-infection. Advances in diagnosis and treatment have improved outcomes, but challenges remain in managing refractory cases. Multidisciplinary approaches are essential for optimal management of fungal keratitis.