Fungal Keratitis Treatment Market Size, Share & Trends Analysis Report By Keratitis Type (Noninfectious Keratitis, Infectious Keratitis), By Drug Class (Polyenes, Azoles, Fluorinated Pyrimidines), By Route of Administration (Oral, Injections, Topical Antifungals), By Age Group (0-18 Years, 18-39 Years, 40-64 Years, 65 Years), By Distribution Channel (Hospitals, Drug stores, Others) and By Region(North America, Europe, APAC, Middle East and Africa, LATAM) Forecasts, 2022-2030

Market Overview

The global fungal keratitis treatment market size was valued at USD 896.09 million in 2023 and is expected to reach USD 1,460.89 million in 2032 at a CAGR of 6.3% during the forecast period (2024 to 2032).

The fungal keratitis treatment market is driven by rising cases of fungal keratitis worldwide, the increasing awareness of the potential dangers posed by fungal keratitis, and the advancements in its therapeutics. It is estimated that the incidence of fungal keratitis would exceed one million cases per year, with 8 to 11 percent of patients losing an eye. Fungal keratitis is an increasingly prevalent infection and for which the Aspergillus species are the most common causal agent for fungal keratitis. 

Trauma, contact lens use, topical corticosteroid use, diabetes mellitus, and low socioeconomic status are risk factors for fungal keratitis. Undoubtedly, accidental ocular trauma is the most prevalent risk factor for fungal keratitis. The estimated prevalence rate of fungal keratitis is based on an infection of the cornea, which is frequently caused by improper care and cleaning of contact lenses or corneal injury. Increasing research activities to develop novel therapeutics and rising sales volume of ophthalmic drugs for fungal keratitis disorders are anticipated to be one of the major market drivers during the forecast period.

Government initiatives, such as awareness campaigns may also contribute to the growth of the fungal keratitis treatment market. In one of India's states, for example, the Government of Assam operates a "National Programme for Control of Blindness" to reduce the prevalence of blindness and its underlying diseases, such as fungal keratitis. It can aid in taking the necessary preventative measures. The provision of better health care facilities and the dissemination of information regarding the benefits of better and earlier diagnoses could serve as a motivating factor.

Market Dynamics

Market drivers

• Growing burden of fungal keratitis disease is a key driver for the fungal keratitis treatment market growth

Fungus-caused keratitis is an infection of the cornea, which is a transparent dome covering the colored portion of the eye. Some fungi known to commonly cause fungal infections are Fusarium, Aspergillus, and Candida species. This condition can cause eye pain, eye redness, vision blurring, light sensitivity, excessive tearing, and eye discharge. Untreated fungal keratitis is a rare condition that can lead to vision loss or blindness. Eye trauma, particularly involving plants (such as thorns or sticks), underlying eye disease, weakened immune system, and contact lens use, is all risk factors for developing fungal keratitis. 

In addition, the increasing prevalence of fungal keratitis across the globe has a positive effect on the market expansion as a whole. According to research, there were 1,051,787 annual cases of fungal keratitis in the earlier days, with the highest rates in Asia and Africa. If it is assumed that all culture-negative cases are caused by fungi, the annual incidence would be 8 to 11%. The highest annual incidence of fungal keratitis and the highest ratio of fungi to bacteria as causes of microbial keratitis are observed in subtropical and tropical countries, primarily among male agricultural workers. 

In addition, the prevalence of fungal keratitis is increasing as the number of people who wear contact lenses rises. The most prevalent predisposing risk factors for infection are contact lens use, associated poor hygiene, and exposure to water sources containing amoebas. Consequently, the increasing number of contact lens wearers exposed to the risk of fungal keratitis propels the market's expansion. Consequently, based on the aforementioned factors, it is evident that the burden of fungal keratitis is increasing, thereby contributing to the expansion of the studied market.

• Increase in research and development activities to boost fungal keratitis treatment market 

Multiple attempts are being made to develop and discover new antifungal treatments for fungal keratitis. For instance, a case report published in Frontiers in Medicine in March 2021 described the molecular diagnosis of fungal keratitis associated with contact lenses caused by Fusarium solani, a common and virulent pathogen. The report highlighted the use of real-time quantitative PCR assay for rapid and accurate identification of the fungal species and suggested the need for more effective and affordable antifungal agents. Thus, the positive results of such techniques may lead to the development of a new treatment, which could stimulate market growth in the coming years. 

In 2021, a new antifungal agent, Rezafungin, received the Breakthrough Therapy designation from the US Food and Drug Administration (FDA) for the treatment of invasive fungal infections. Rezafungin is a novel echinocandin that has a long half-life and can be administered once weekly. It is expected to offer advantages over existing antifungal drugs, such as lower toxicity, better tissue penetration, and broader spectrum of activity. Rezafungin is currently in phase 3 clinical trials for the treatment of fungal keratitis and other fungal infections. Thus, the introduction of Rezafungin may lead to the development of a new treatment, which could stimulate market growth in the coming years. 

Such type of research advancements have resulted in numerous breakthrough innovations of highly effective drugs against various fungal keratitis diseases, which has led the majority of investors to favor investing in R&D and has contributed to market expansion. As a result, the market is likely to expand at a faster rate in the coming years as a result of the aforementioned factors.

Market restraints

• Side effects associated with the fungal keratitis treatment proving to be major setback for the fungal keratitis treatment market growth

Widespread use of antifungal medications for the treatment of this condition is accompanied by the occurrence of side effects. These side effects are typically mild and short-lived. Redness of the eye, severe pain, and soreness of the eye, the sensation of having something in the eye, tearing, pus or other discharge, blurred vision, sensitivity to light, and swelling of the eyelids are potential side effects of fungal keratitis treatment. Typically, these adverse effects are mild and short-lived. In addition, these medications are generally well-tolerated and safe, with only the possibility of local side effects. 

Additionally, it has been discovered that the use of counterfeit medications for the treatment of fungal keratitis results in a variety of adverse effects for the patient. Consequently, all of these adverse effects caused by antifungal keratitis medications and the loss of patent protection for blockbuster drugs have acted as a restraint on market growth.

Market opportunity

• Increase in research and development activities to boost fungal keratitis treatment market 

Multiple attempts are being made to develop and discover new antifungal treatments for fungal keratitis. For instance, a case report published in Frontiers in Medicine in March 2021 described the molecular diagnosis of fungal keratitis associated with contact lenses caused by Fusarium solani, a common and virulent pathogen. The report highlighted the use of real-time quantitative PCR assay for rapid and accurate identification of the fungal species and suggested the need for more effective and affordable antifungal agents. Thus, the positive results of such techniques may lead to the development of a new treatment, which could stimulate market growth in the coming years. 

In 2021, a new antifungal agent, Rezafungin, received the Breakthrough Therapy designation from the US Food and Drug Administration (FDA) for the treatment of invasive fungal infections. Rezafungin is a novel echinocandin that has a long half-life and can be administered once weekly. It is expected to offer advantages over existing antifungal drugs, such as lower toxicity, better tissue penetration, and broader spectrum of activity. Rezafungin is currently in phase 3 clinical trials for the treatment of fungal keratitis and other fungal infections. Thus, the introduction of Rezafungin may lead to the development of a new treatment, which could stimulate market growth in the coming years. 

Such type of research advancements have resulted in numerous breakthrough innovations of highly effective drugs against various fungal keratitis diseases, which has led the majority of investors to favor investing in R&D and has contributed to market expansion. As a result, the market is likely to expand at a faster rate in the coming years as a result of the aforementioned factors.

Regional Analysis

The global fungal keratitis treatment market is primarily divided into three regions, North America, Europe, and Asia.

North America region is the largest market for fungal keratitis treatment, with a market size of USD 299.02 million in 2023 and a projected market size of USD 317.04 million by 2032, at a CAGR of 5.2%. The market growth in this region is driven by the high prevalence of fungal keratitis, the increasing awareness of the disease, the availability of advanced diagnostic and therapeutic options, and the presence of key players in the market.

Europe is the second largest market for fungal keratitis treatment, with a market size of USD 201.01 million in 2023 and an expected market size of USD 315.56 million by 2032, at a CAGR of 5.8%. The market growth in this region is influenced by the rising incidence of fungal keratitis, the growing demand for effective and affordable antifungal drugs, and the increasing research and development activities in the field.

Asia-Pacific is the fastest growing market for fungal keratitis treatment, with a market size of USD 258.09 million in 2023 and an anticipated market size of USD 408.26 million by 2032, at a CAGR of 5.9%. The market growth in this region is fueled by the large population base, the high rate of ocular trauma, the low socioeconomic status, and the improving healthcare infrastructure and access.

Segmental Analysis

The global fungal keratitis treatment market share is segmented on the basis of Keratitis Type, Drug Class, Route of Administration, Age Group, and  Distribution Channel.

Based on the drug class, the market is segmented into Polyenes, Azoles, and Fluorinated Pyrimidines. Polyenes such as amphotericin B are often used for severe fungal keratitis, particularly caused by Candida species. Azoles such as voriconazole and ketoconazole are typically used for fungal keratitis, and voriconazole, in particular, has shown efficacy against a wide range of fungal pathogens. Fluorinated Pyrimidines are another class of antifungal drugs and are less common compared to the other two drug classes.

With respect to the route of administration, it is further segmented as an oral, injection, and topical. The topical segmentation is the most dominant one, with a market share of USD 199.4 million in 2023 and expected to reach USD 310.69 million by 2032 at a CAGR of 5.7%. Topical antifungals, either commercially available or compounded from a systemic preparation into eye drops, are the most frequently prescribed medications for the treatment of fungal keratitis.

The only topical antifungal medication approved for the treatment of fungal keratitis is natamycin. However, inadequate ocular penetration is the primary market constraint. On the other hand, due to the approval of new topical formulations for fungal keratitis, the topical route of administration is anticipated to experience substantial growth over the forecast period.

The oral route of administration is the second most utilized one, which has a market value of USD 167.6 million in 2023 and reaching at USD 259.17 million by 2032 at a CAGR of 5.6%. Oral treatment is conventional and the most reliable route of drug administration, with effective systemic and local effects. In addition, both the physician and the patient favor this route of drug administration.

The distribution channel, the said market is segmented into hospitals and drug stores,and others, where the hospital segment accounted for the largest market share of USD 294 million in 2023 and is forecasted to reach USD 441.04 million by 2032, at a CAGR of 5.2%.

Drug store is anticipated to hold second largest market share of USD 211.34 million in 2023 and is estimated to grow to USD 314.63 million by 2032, at a CAGR of 5.1%. Independent pharmacies with a state license to dispense medications to the general public at retail prices are referred to as drug stores.

Recent Developments

1. In April 2022, Bausch + Lomb presented 13 scientific posters at the ARVO annual meeting, featuring results from a Phase 3 trial of NOV03, an investigational treatment. They also highlighted their product XIPERE for Suprachoroidal Use, and shared insights from the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) surveillance study.
2. In December 2021, Avanos Medical annouced the acquistion of OrthogenRx, Inc., a leading provider of viscosupplementation therapies for knee osteoarthritis (OA) pain, for USD 160 Million.